March 2, 2021 Dear Prospective Offerors: Subject: Request for Quotations Number 19JA80-21-Q-0307 Food Services Program The Embassy of the United States of America seeks to enter into a contract with a qualified, responsible, and reliable firm with sufficient knowledge and facilities for professional food services program for the U.S. Embassy Tokyo Marine Security Guards at the U.S. Embassy Apartment Compound in Tokyo, Japan. Note: As required by U.S. Government’s federal acquisition regulation (FAR), prospective offeror shall be registered in the System for Award Management (SAM) database prior to award of a contract. The website link providing additional vendor registration information is: https://www.sam.gov/SAM/.
If you are interested in submitting a quote on this project, follow the instructions in Section 3: Solicitation Provisions of the Request for Quotations (RFQ), complete the required portions of the enclosed document, and submit as the indicated shown on the next page. 1. Pre-quotation Briefing and Site Visit (a) To provide all the quoters with a uniform explanation of requirements, the Embassy will hold a pre-quotation conference and site visit, as follows: Date: Wednesday, March 10, 2021 Time: From 10:00 a.m. to on/about 11:30 a.m. (JST) Location: Meet at the Grew Gate of the Apartment Compound of U.S.
Embassy, 2-1-1 Roppongi, Minato-ku, Tokyo 106-0032
(b) All interested quoters who wish to attend must submit individual name (s), limited to two persons per company, company name/address, telephone/fax numbers, and email address to Masao Chuma via email at [email protected] by no later than 3:00 p.m., Monday, March 8, 2021 (Japan Standard Time), to arrange entry to the Compound. (c) Attendee(s) must present an identification (ID) card with photo on it (e.g. driver’s license, passport, etc.) as it is required for entering the Compound. (d) Photography is NOT ALLOWED. Embassy will provide approved photos on webpage when request arise.
Embassy of the United States of America Tokyo, Japan
-2-
2. Questions Following the conference, quoters may submit questions (in English) in regard to this RFQ by 3:00 p.m., Monday, March 15, 2021 (JST) via email at [email protected]. All questions will be consolidated and one response will be prepared and posted on the Embassy’s website, the same website from where you obtained the solicitation documents.
3. Quotations Quotations must be received by no later than 12:00 noon, Wednesday, March 24, 2021 (Japan Standard Time) to Masao Chuma of U.S. Embassy Tokyo, via email to the indicated below. No quotation will be accepted after this time. Point of Contact: Masao Chuma – Procurement Agent Email: [email protected] Subject: RFQ 19JA80-21-Q-0307 Mobile: 090-1110-9306 Embassy Telephone Operator: 03-3224-5000
It is understood that no payment will be made for preparation and submission of your quotation. Thank you in advance for your interest and your time in participating in the request for quotations process. Sincerely, Darin A. Phaovisaid Contracting Officer Enclosure: Request for Quotations 19JA80-21-Q-0307
REQUEST FOR QUOTATIONS (RFQ)
(THIS IS NOT AN ORDER)
THIS RFQ [ ] IS [ x ] IS NOT A SMALL BUSINESS-
SMALL PURCHASE SET-ASIDE (52.219-4)
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1. REQUEST NO.
19JA80-21-Q-0307
2. DATE ISSUED
March 2, 2021
3. REQUISITION/PURCHASE REQUEST NO.
PR9694471
4. CERT. FOR NAT. DEF.
UNDER BDSA REG. 2
AND/OR DMS REG. 1
RATING
5A. ISSUED BY
GSO/Procurement Unit
U.S. Embassy
1-10-5 Akasaka
Minato-ku, Tokyo 107-8420
6. DELIVER BY (Date)
5B. FOR INFORMATION CALL: (Name and telephone no.) (No collect calls 7. DELIVERY
X FOB DESTINATION OTHER (See Schedule) NAME
Masao Chuma TELEPHONE NUMBER
AREA CODE
+81 NUMBER
3-3224-5752 8. TO: 9. DESTINATION
a. NAME b. COMPANY a. NAME OF CONSIGNEE
U.S. Embassy
c. STREET ADDRESS b. STREET ADDRESS
1-10-5 Akasaka, Minato-ku
d. CITY e. STATE f. ZIP CODE c. CITY
Tokyo
d. STATE
e. ZIP CODE
107-8420
10. PLEASE FURNISH QUOTATIONS TO THE ISSUING
OFFICE IN BLOCK 5A ON OR BEFORE:
Wednesday, March 24, 2021;
12:00 noon (JST)
IMPORTANT: This is a request for information, and quotations furnished are not offers. If you are unable to quote,
please so indicate on this form and return it to the address in Block 5A. This request does not commit the Government to
pay any costs incurred in the preparation of the submission of this quotation or to contract for supplies or services. Supplies
are of domestic origin unless otherwise indicated by quoter. Any representations and/or certifications attached to this
Request for Quotations must be completed by the quoter
11. SCHEDULE (Include applicable Federal, State and local taxes)
ITEM NO.
(a)
SUPPLIES/SERVICES
(b)
QUANTITY
(c)
UNIT
(d)
UNIT PRICE
(e)
AMOUNT
(f)
1
Food services program for the U.S. Embassy
Tokyo Marine Security Guards at the U.S.
Embassy Apartment Compound in Tokyo, Japan,
in accordance with terms and conditions of
the request for quotations.
This RFQ incorporates FAR clause 52.212-4 and
provision 52.212-1 by reference.
(See subsection 1.3 Grand Total Price
under Section 1)
12 DISCOUNT FOR PROMPT PAYMENT a. 10 CALENDAR DAYS
%
b. 20
CALENDAR
DAYS
%
c. 30 CALENDAR DAYS
%
d. CALENDAR DAYS
NUMBER %
NOTE: Additional provisions and representations [ √ ] are [ ] are not attached.
13 NAME AND ADDRESS OF QUOTER 14 SIGNATURE OF PERSON AUTHORIZED TO SIGN
QUOTATION
15 DATE OF QUOTATION
a. NAME and ADDRESS OF QUOTER (COMPANY)
DUNS No.:
c. COUNTY 16. SIGNER a. NAME (Type or print)
b. TELEPHONE
d. CITY e. STATE f. ZIP CODE c. TITLE (Type or print)
AREA CODE
NUMBER
AUTHORIZED FOR LOCAL REPRODUCTION STANDARD FORM 18 (Rev. 6-95) Previous edition not usable Prescribed by GSA-FAR (48 CFR) 53.215-1(a)
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
Page 2 of 67
TABLE OF CONTENTS
Standard Form 18 (SF-18), the first page
Section 1: The Schedule
1.1 Continuation to SF-18, Request for Quotations (RFQ) Number
19JA80-21-Q-0307, Blocks 11(f), Amount
1.2 Continuation to SF-18, Request for Quotations (RFQ) Number
19JA80-21-Q-0307, Block 11(b), Schedule of Supplies/Services
Section 2: Contract Clauses
2.1 Contract Clauses
2.2 Addendum to Contract Clauses – FAR and DOSAR Clauses not
Prescribed in Part 12
Section 3: Solicitation Provisions
3.1 Solicitation Provisions
3.2 Summary of Instructions
3.3 Addendum to Solicitation Provisions – FAR and DOSAR Provisions
not Prescribed in Part 12
Section 4: Evaluation Factors
4.1 Evaluation Factors
4.2 Addendum to Addendum to Evaluation Factors – FAR and DOSAR
Provisions not Prescribed in Part 12
Section 5 - Representations and Certifications
5.1 Offeror Representations and Certifications
5.2 Addendum to Offeror Representations and Certifications – FAR and
DOSAR Provisions not Prescribed in Part 12
Attachments:
Attachment 1 - Description/Specifications/Performance Work Statement
Attachment 2 - Government Furnished Property
Attachment 3 - Japanese Holidays during Year 2021
Attachment 4.- English Speaking Levels
Attachment 5 – Tokyo Security Form
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
Page 3 of 67
Section 1: The Schedule
Continuation to SF-18, Request for Quotations (RFQ) Number 19JA80-21-
Q-0307, Blocks 23, Blocks 11, (e) Unit Price, and (f) Amount
1. PRICE AND PERIOD OF PERFORMANCE
1.1 The Contractor shall perform food services work, including
furnishing all labor, material, equipment, and services, for the U.S.
Embassy Tokyo Marine Security Guards in Japan. The price listed
below shall include all labor, materials, insurance (see FAR clauses
52.228-4 and 52.228-5 in Section 2 of this RFQ), overhead, and
profit. The U.S. Government will pay the Contractor the fixed price
per month for standard services that have been satisfactorily
performed. Food is purchased separately by Mess NCO (after approval
of 30 day menu) and maybe accompanied by the Contractor if needed.
After contract award and submission of acceptable insurance
certificates, the Contracting Officer shall issue a Notice to
Proceed. The Notice to Proceed will establish a date on which
performance shall start.
The performance period of this contract is from May 1, 2021 through
April 30, 2022, with four one-year options to renew. The initial
period of performance includes any transition period authorized
under the contract.
The U.S. Embassy Tokyo is exempt from Japanese consumption taxes;
therefore, such taxes shall not be included in the price nor charged
on invoices. After receipt of the Contractor’s invoice, the U.S.
Government will provide the Contractor with a signed Certificate of
Tax Exemption Purchase for Foreign Establishments. (For non-
Designated Stores, please visit the following link for registration:
http://www.nta.go.jp/taxes/tetsuzuki/shinsei/annai/shohi/annai/23120
184.htm)
1.2 Offers and Payment in U.S. Dollars
(a) U.S. firms are eligible to be paid in U.S. dollars. U.S.
firms desiring to be paid in U.S. dollars should submit their
offers in U.S. dollars. A U.S. firm is defined as a company which
operates as a corporation incorporated under the laws of a state
within the United States.
(b) Foreign Firms. Any firm, which is not a U.S. firm, is a
foreign firm. Any firm that does not meet the above definition of
U.S. firm shall submit its prices and receive payment in Japanese
Yen.
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
Page 4 of 67
1.3 Pricing
(a) Base Year. The firm fixed price for the Base Year (May 1,
2021 through April 30, 2022) of the contract is:
Per month ________________ x 12 = __________________per year
(b) First Option Year. The firm fixed price for the First Option
Year (May 1, 2022 through April 30, 2023) of the contract
Per month ______________ x 12 = _________________per year
(c) Second Option Year. The firm fixed price for the Second
Option Year (May 1, 2023 through April 30, 2024) of the contract
is:
Per month ______________ x 12 = _________________per year
(d) Third Option Year. The firm fixed price for the Third Option
Year (May 1, 2024 through April 30, 2025) of the contract is:
Per month ______________ x 12 = _________________per year
(e) Fourth Option Year. The firm fixed price for the Fourth
Option Year (May 1, 2025 through April 30, 2026) of the contract
is:
Per month ______________ x 12 = _________________per year
(f) Grand Total.
Base Year (1.3(a)): __________________
First Option Year (1.3(b)): __________________
Second Option Year (1.3(c)): __________________
Third Option Year (1.3(d)): __________________
Fourth Option Year (1.3(e)): __________________
Grand Total – Base and All Option Years: __________________
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
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Continuation to SF-18, Request for Quotations (RFQ) Number 19JA80-21-
Q-0307, Block 11(b), Schedule of Supplies/Services
2. SCOPE OF WORK
The purpose of this fixed price contract is to obtain food services
program for the U.S. Embassy Tokyo, Japan, for Marine Security
Guards at the Marine Security Guard Residence (MSGR). The
Contractor shall perform services in designated spaces. The
contract will be for a one-year period May 1, 2021 through April 30,
2022, with four one-year options.
The Contractor shall furnish all managerial, administrative, and
direct labor personnel that are necessary to accomplish the work in
this contract. Contractor employees shall be on site only for
contractual duties and not for other business purposes.
2.1 General Instructions. The Contractor shall prepare general
instructions for the work force. The Contractor shall provide
drafts to the Contracting Officer's Representative (COR) for review
within thirty days after contract award. The Contracting Officer’s
Representative must approve these general instructions before
issuance.
The Contractor shall establish and operate a food service for the
purpose of providing Marine Detachment employees meal preparation
services, for breakfast, lunch and dinner, five days a week,
between 7:30-16:00 Monday through Friday with a 30 minutes lunch
break, excluding Japanese holidays listed in Attachment 3. The
meals should be prepared on site at the Marine Security Guard
Residence (MSGR). Under the five days a week plan, the Contractor
shall prepare meals for the weekend and store them in location
approved by the COR.
Meals should be prepared in accordance with weekly guidelines and
ingredients from Mess Non-Commissioned Officer (NCO).
Sample of weekly menu:
Weekday Breakfast Lunch Dinner
Monday Upon Marines
Request
&
Marines at work
Upon Marines
Request
Chicken and Rice
&
Steak and Veggies
Tuesday 0930 Detachment
Breakfast
&
Marines at work
Upon Marines
Request
Salmon and Rice
&
Chicken and Potatoes
Wednesday Upon Marines
Request
&
Marines at work
Upon Marines
Request
Beef Taco and Veggies
&
Porkchop and Rice
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
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Thursday Upon Marines
Request
&
Marines at work
Upon Marines
Request
Pasta with red or
white sauce
&
Chicken and Veggies
Friday Upon Marines
Request
&
Marines at work
Upon Marines
Request
Meatloaf and Mash
Potatoes
&
Steak and Veggies
Chicken and Rice
&
Porkchop and Veggies
^
Enough for Saturday
and Sunday
2.2 Duties and Responsibilities. Contractor is required to provide
meal services as directed in Attachment 1 as specified in the meal
plan provided by Mess NCO. Change to the meal plans can only be
made with the concurrence of the Mess NCO. Occasionally, cook must
be prepared to cook extra food for events like Detachment meals. In
this case, Mess NCO will give two week advance notification.
2.2.1 While working at the Residence, the contractor is allowed
access to the common areas only. This is generally considered the
ground floor. The Contractor is not allowed access to the upper
floors of the residence at any time without an escort from a
member of the residence. Signs are posted throughout the Marine
House depicting off limit areas.
2.2.2 The Contractor shall schedule cooking and serving
requirements to ensure that these are done in the order and time
frame specified and they are to be performed on a daily basis,
Monday-Friday. Work hours will be from 07:30-16:00 daily, Monday
through Friday with a break between 12:30-13:00.
The evening meal should be plated individually, in trays or
containers according to Mess NCO instructions and properly stored
in the fridge before departing for the day.
2.2.3 The Contractor shall clean kitchen, all dishes, utensils and
appliances, and dining areas after each meal and cause minimal
disruption to the normal operation of the facility. The COR shall
determine the schedules presented which meet the needs of the
individual facility.
2.3 Types of Services. The type of services shall include the
following work:
Daily Cooking and Serving Requirements:
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
Page 7 of 67
SEE ATTACHMENT 1
3. MANAGEMENT AND SUPERVISION
3.1 The Contractor shall designate a supervisor who shall be
responsible for the Contractor's workforce at all times. This
supervisor shall be the focal point for the Contractor and shall be
the point of contact with U.S. Government personnel. The supervisor
shall have a background in nutrition, experience in food service
industry and strong English language skill of Level 3 of Attachment
4 – English Speaking Levels to be able to communicate with members
of the U.S. Government staff. It is possible the onsite work force
would only be the MSG Detachment Cook. In this instance, a
supervisor must be available by telephone and have the ability to
respond to the residence within one hour.
3.2 The Contractor shall maintain schedules. The schedules shall
take into consideration the hours that the staff can effectively
perform their services without placing a burden on the security
personnel of the U.S. Government. The Contractor shall have a
sufficient number of personnel available to work onsite in the
eventuality of the unavailability of the primary worker.
3.3 The Contractor shall be responsible for quality control. In
coordination with the COR, the Contractor shall perform inspection
visits to the work site on a quarterly basis. The Contractor shall
coordinate these visits with the COR. These visits shall be
surprise inspections to those working on the contract. The
Contractor shall develop an inspection checklist for approval by the
COR.
3.4 The Contractor shall perform quarterly counseling sessions with
the MSG Detachment Cook based on a template and feedback provided by
the Mess NCO. The counseling sessions shall be documented in
writing and submitted within 15 days after the completion of the
counseling session to the COR and Mess NCO for record keeping.
3.5 The Contractor shall control overtime through efficient use of
the work force. Individual work schedules shall not exceed 40 hours
per week to preclude overtime being part of the services provided
under the contract.
4. LOCATIONS FOR FOOD SERVICES
All services are to be delivered every day Monday through Friday,
excluding designated Japanese holidays listed in Attachment 3, for
up to fourteen [14] USG Marine security personnel in providing
breakfast, lunch and dinner daily at the MSGR for US Embassy. Under
the five days a week plan, the Contractor shall prepare and store
dinner meals according to the Mess NCO’s instruction before weekends
or holidays to cover the days the Contractor will not be present. As
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
Page 8 of 67
required, the Cook shall package a certain set of take away meals
daily for morning and afternoon delivery for consumption off site.
The Contractor will be notified of the quantity of boxed meals
required for the day by USG MSG Marine security personnel.
Location Number of
people
Estimated
Service
Scheduled
Hours
Escort
MSGR 14 people 3
meals/person/day
0730-1600 no
Breakfast
The cook shall call Post One at ext.25600 to ask Marines what they
want. Then, the Cook shall make the said meal and put it in a
container(s). The Cook shall give said container(s) at 0900 to
Embassy driver to bring to the Marine at work.
There are no set options, the Marines will say what they want and if
they want a meal at all.
There will be no premade breakfast unless requested by Marine.
Every Tuesday, the Cook shall make a Detachment breakfast for all
Marines to be served at 0930. The breakfast shall include scrambled
eggs, bacon, hash browns, pancakes, and orange juice.
Lunch
The cook shall receive requests and prepare meals in accordance to
the requests. There are no set options as they Marines shall say
what they want and if they want a meal at all. There will be no
premade lunch unless requested by Marine.
Dinner
The cook shall prepare two (2) dinner meal options for the Marines
according to the menu provided by the Mess NCO and properly store
them in the fridge. The cook shall also accept and prepare special
meal request made by Marines tailored to them for working out or
dieting.
On Fridays, the contractor shall prepare enough of 2 dinner options
to last through Saturday and Sunday. The contractor shall adjust the
quantity based on premade dinner orders requested by the Marines.
There will be no premade breakfast or lunch unless requested by
Marine.
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
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5. PERSONNEL
5.1 General. The Contractor shall maintain discipline at the site
and shall take all reasonable precautions to prevent any unlawful,
riotous or disorderly conduct by Contractor employees at the site.
The Contractor shall preserve peace and protect persons and property
on site. The Government reserves the right to direct the Contractor
to remove an employee from the worksite for failure to comply with
the standards of conduct. The Contractor shall immediately replace
such an employee to maintain continuity of services at no additional
costs to the Government.
5.2 Standard of Conduct. Uniform/Appropriate Attire and Personal
Equipment. The Contractor's employees shall wear clean, neat and
complete uniforms/appropriate attire when on duty. All employees
shall wear attire approved by the Contracting Officer's
Representative (COR).
5.2.1 Neglect of duties shall not be condoned. The Contractor
shall enforce no sleeping while on duty, unreasonable delays or
failures to carry out assigned tasks, conducting personal affairs
during duty hours and refusing to render assistance or cooperate
in upholding the integrity of the worksite security.
5.2.2 Disorderly conduct, use of abusive or offensive language,
quarreling, intimidation by words, actions, or fighting shall not
be condoned. Also included is participation in disruptive
activities, which interfere with normal and efficient Government
operations.
5.2.3 Intoxicants and Narcotics. The Contractor shall not allow
its employees while on duty to possess, sell, consume, or be under
the influence of intoxicants, drugs or substances that produce
similar effects.
5.2.4 Criminal Actions. Contractor employees may be subject to
criminal actions as allowed by law in certain circumstances.
These include but are not limited to the following actions:
-falsification or unlawful concealment, removal, mutilation, or
destruction of any official documents or records or concealment
of material facts by willful omission from official documents or
records;
-unauthorized use of Government property, theft, vandalism, or
immoral conduct;
-unethical or improper use of official authority or credentials;
security violations; or, organizing or participating in gambling
in any form.
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
Page 10 of 67
5.2.5 Key Control. The Cook shall receive, secure, and account for
any code issued for access to buildings, offices, equipment,
gates, etc., for the purposes of this contract. The Cook shall
memorize the code and shall not write the code down without the
COR's approval. Where it is determined that the Contractor or its
agents have written the code or shared the code without permission
of the COR, the Contractor shall remove the individual(s)
responsible from this contract. If the Contractor has compromised
the code, the Contractor shall immediately notify the COR.
5.3 Notice to the Government of Labor Disputes
The Contractor shall inform the COR of any actual or potential
labor dispute that is delaying or threatening to delay the timely
performance of this contract.
5.4 Personnel Security
After award of the contract, the Contractor shall provide a
completed Regional Security Office (RSO) Tokyo Security Form (see
Attachment 5) on each employee, including the substitute
employee(s), who will be working under the contract. The
Contractor shall include a list of workers and supervisors
assigned to this project. The Government will run background
checks on these individuals. It is anticipated that security
checks will take thirty days to perform.
The Government shall issue identity cards to Contractor personnel,
after they are approved. Contractor personnel shall display
identity card(s) on the uniform/attire at all times while
providing services under this contract. These identity cards are
the property of the US Government. The Contractor is responsible
for their return at the end of the contract, when an employee
leaves Contractor service, or at the request of the Government.
The Government reserves the right to deny access to U.S.-owned and
U.S.-operated facilities to any individual. Although there is no
uniform requirement, the Contractor shall ensure all employees
arrive to work in clean and appropriate clothing. Clothing should
help inspire a sense of pride, authority, and comradery among
employees. The food service clothing shall be commensurate with a
high-quality operation and communicate a positive first impression
for guests. In addition to appearance the clothing shall take
into consideration employee safety (non-slick shoes to prevent
slipping, long sleeve chef coat to avoid burns, aprons, masks,
face shield, hair nets, etc.)
5.5 Employee Safety Requirements
The Contractor shall ensure that employees are supplied with and
use proper safety personal protective equipment (PPE) such as
aprons, potholders, face shields, hair nets and masks. The
Contractor employees will follow signed safety work procedures,
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
Page 11 of 67
which protect the Contractor employees and U.S. Government
personnel in proximity to work site.
5.6 Key Personnel
5.6.1 Position and Function. The key personnel specified in this
contract are essential to work performance. The only position
considered in this contract is the Supervisor and MSG Detachment
Cook. The contractor shall provide two (2) alternative cooks to
fill in for absences of the primary MSG Detachment Cook.
5.6.2 Minimum Qualifications
MSG Detachment Cook. The MSG Detachment Cook is the culinary
lead of the program and is responsible for the development of
menus, food storage, and cleanliness of the MSGR kitchen and
dining areas. The MSG Cook shall have a minimum of 3 years’
experience managing food services operations demonstrating
experience in premium level food and service execution. The MSG
Cook should have English language skills at the 2/2 level.
Clearance Level: None
Alternate cook. The alternate MSG Detachment Cook is the back up
of the primary MSG Detachment cook and is responsible for the
development of menus, food storage, and cleanliness of the MSGR
kitchen and dining areas in the absence of the MSG primary
cook. The alternate MSG Cook shall have a minimum of 3 years’
experience managing food services operations demonstrating
experience in premium level food and service execution. The
alternate MSG Cook should have English language skills at the 2/2
level.
5.6.3 Substitutions
During the first 180 days of performance (after transition), the
Contractor will make no substitutions of key personnel unless the
substitution is required due to illness, death, or termination of
employment. The Contractor will notify the Contracting Officer
within 5 calendar days after the occurrence of any of these
events.
5.6.4 Replacements
After the first 180 days of performance, the Contractor may
substitute the key person if they determine that it is necessary.
The Contractor will provide notice at least 45 days prior to
diverting any of the specified individuals to other programs or
contracts (or as soon as possible, if an individual must be
replaced, for example, as a result of leaving the employ of the
Contractor). The Contractor will notify the CO and shall submit
comprehensive justification for the diversion or replacement
request (including proposed substitutions for key personnel) to
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
Page 12 of 67
permit evaluation by the Government of the impact on performance
under this contract. The proposed substitute shall possess
qualifications comparable to the original key person and meet the
minimum standards set forth in the contract.
5.6.5 Written Approval and Consent
The Contractor shall not divert or otherwise replace any key
personnel without the written consent of the CO. The Government
will modify the contract to reflect any changes in key personnel.
6. MATERIALS AND EQUIPMENT
After inspection of the kitchen facilities, the Contractor shall
provide to the COR and the Mess NCO a list of any items needed to
successfully carry out the duties and responsibilities of this
contract. These items will be provided by the Government, are
considered government property and will at all times remain onsite.
7. GOVERNMENT FURNISHED PROPERTY/EQUIPMENT
7.1 The Contractor has the option to reject any or all Government
furnished property or items (see Attachment 2 - GOVERNMENT FURNISHED
PROPERTY). However, if rejected, the Contractor shall provide all
necessary property, equipment or items, adequate in quantity and
suitable for the intended purpose, to perform all work and provide
all services at no additional cost to the Government. An inventory
will be conducted. All Government furnished property or items are
provided in an "as is" condition and shall be used only in
connection with performance under this contract. The Contractor is
responsible for the proper care, maintenance and use of Government
property in its possession or control from time of receipt until
properly relieved of responsibility in accordance with the terms of
the contract. The Contractor shall pay all costs for repair or
replacement of Government furnished property that is damaged or
destroyed due to Contractor negligence.
7.2 The Contractor shall maintain written records of work performed,
and report the need for major repair, replacement and other work for
Government property in its control.
The Contractor shall physically inventory all Government property
in its possession. Physical inventories consist of sighting,
tagging or marking, describing, recording, reporting and
reconciling the property with written records. The Contractor
shall conduct these physical inventories periodically, as directed
by the COR, and at termination or completion of the contract.
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
Page 13 of 67
8. INSURANCE
8.1 Amount of Insurance. The Contractor is required to provide
whatever insurance is legally necessary. The Contractor shall, at
its own expense, provide and maintain during the entire performance
period the following insurance amounts:
8.2 General Liability (includes premises/operations, collapse
hazard, products, completed operations, contractual, independent
contractors, broad form property damage, personal injury)
(a) Bodily Injury stated in Japanese Yen:
Per Occurrence ¥30,000,000
Cumulative ¥90,000,000
(b) Property Damage stated in Japanese Yen:
Per Occurrence ¥3,000,000
Cumulative ¥9,000,000
8.3 The types and amounts of insurance are the minimums required.
The Contractor shall obtain any other types of insurance required by
local law or that are ordinarily or customarily obtained in the
location of the work. The limit of such insurance shall be as
provided by law or sufficient to meet normal and customary claims.
8.4 For those Contractor employees assigned to this contract who are
either United States citizens or direct hire in the United States or
its possessions, the Contractor shall provide workers’ compensation
insurance in accordance with FAR 52.228-3.
8.5 The Contractor agrees that the Government shall not be
responsible for personal injuries or for damages to:
(a) any property of the Contractor,
(b) its officers,
(c) agents,
(d) servants,
(e) employees, or
(f) any other person
arising from an incident to the Contractor's performance of this
contract. The Contractor shall hold harmless and indemnify the
Government from any and all claims arising, except in the instance
of gross negligence on the part of the Government.
8.6 The Contractor shall obtain adequate insurance for damage to, or
theft of, materials and equipment in insurance coverage for loose
transit to the site or in storage on or off the site.
8.7 Government as Additional Insured. The general liability policy
required of the Contractor shall name "the United States of America,
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acting by and through the Department of State", as an additional
insured with respect to operations performed under this contract.
8.8 Time for Submission of Evidence of Insurance. The Contractor
shall provide evidence of the insurance required under this contract
within 10 calendar days after contract award. The Government may
rescind or terminate the contract if the Contractor fails to timely
submit insurance certificates identified above.
9. LAWS AND REGULATIONS
9.1 Without additional expense to the Government, the Contractor
shall comply with all laws, codes, ordinances, and regulations
required to perform this work. In the event of a conflict among the
contract and requirements of local law, the Contractor shall
promptly advise the Contracting Officer of the conflict and of the
Contractor's proposed course of action for resolution by the
Contracting Officer.
9.2 The Contractor shall comply with all local labor laws,
regulations, customs and practices pertaining to labor, safety, and
similar matters, to the extent that such compliance is not
inconsistent with the requirements of this contract.
10. TRANSITION PLAN
Within 10 days after contract award, the Contracting Officer may
request that the Contractor develop a plan for preparing the
Contractor to assume all responsibilities for cook services. The
plan shall establish the projected period for completion of all
clearances of Contractor personnel, and the projected start date for
performance of all services required under this contract. The plan
shall assign priority to the selection of all supervisors to be used
under the contract.
11. DELIVERABLES
The following items shall be delivered under this contract:
Description Quantity
Delivery
To Date
1.1 General
Instructions 1 COR 30 days after award
1.2.3 Schedules 1 COR Weekly
4.4.1 List of
Personnel 1 COR 10 days after award
7. Evidence of
Insurance 1 COR 10 days after award
8. Licenses and
Permits 1 COR Date of award
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9. Transition
Plan 1 COR 10 days after award
Daily Headcount
by Meal
COR Available daily, due
monthly along with running
annual to-date totals
20-Day Menu Plan
COR 1 week prior to start of
new menu cycle
Menu Adjustments
COR 1 week in advance of
change
Menu
Acceptability and
Waste Report 1
COR Monthly
Menu Metrics 1
COR Monthly
Hazard Analysis
and Critical
Point (HACCP)
Plan 1
COR Prior to start of
performance
Illness Reports
COR Provide as part of the
Program Management and QA
Reviews
Food Storage
Catalogue
1
COR Prior to start of Option
Year, updated when new
items are developed
Food Storage
Catalogue
proposed changes
COR Provide proposed change to
COR for review and
approval prior to
formalization of change
Reporting Plan 1
COR Start of performance
Risk Management
Plan (Risk
management and
mitigation-
quality control &
assurance, etc.) 1
COR Provide as part of
proposal response and
updated/maintained
throughout performance
Quality Control
Plan
1
COR Prior to Start of
Performance and each
Option Year
Food concession,
food, and water
inspection SOPs 1
COR Within first 30 days
Quality Control
Reports 1
COR Monthly
Vulnerability
Assessment 1
COR Monthly
KPI Reporting 1
COR Monthly to COR to CO
Food Service
Operation Uniform
plan 1
COR Within first 30 days
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Health, Safety
and Environment
Plan 1
COR Within first 30 days
Counseling
documentation for
Cook 1
COR Quarterly
Site Inspection
report 1
COR Quarterly
Site Inspection
Checklist 1
COR Within first 30 days
Annual physical
of primary and
alternate MSG
cook 4
COR 10 days after awarad and
annually thereafter
12. QUALITY CONTROL MANAGEMENT, QUALITY ASSURANCE AND SURVEILLANCE
PLAN (QASP)
Quality Control. The Contractor, prior to implementation, shall
provide for DOS approval a Quality Control plan, that will include
food service performance standards, metrics, and reporting required
for quality control.
This plan shall define the contractor’s approach to Quality
Assurance/Quality Control on the contract. It shall provide an
overview of the contractor’s approach to the planning, organization,
direction, and control of quality-related activities associated with
the delivery and performance of products and services.
Contractor shall specifically provide oversight to all food
inspection activities while working within the requirements set
forth by food service standards and regulations, the DOSDOS Regional
Medical Officer (RMO) and Department of State (DOS) Contracting
Officer’s Representative (COR) in completing the following duties:
Food Handling Procedure
Adherence to HACCP
Menu Execution and Presentation
MSGR kitchen inspections
Food Storage inspections
12.1 Food Inspection Resources
The Contractor shall provide resources to perform food
procurement, food handler training, public and food facility
inspections, vulnerability assessments and QA/QC monthly reports
for the MSGR kitchen and dining areas. These requirements shall
meet or exceed established FDA, USDA requirements. MSGR kitchens
shall be inspected on a routine basis or as determined by the
individual sanitation history and the potential risk associated
with the number of personnel eating at a single site. The
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Contractor’s Food Service employees shall receive periodic
refresher training and a medical records review of new employees.
The Contractor’s food service employees shall be medically cleared
prior to returning to work after receiving medical care.
12.2 Standard Operating Procedures (SOP)
The Contractor will develop MSG kitchen usage food, and water
inspection SOPs and, upon COR approval of the SOPs, apply the SOPs
during periodic site inspections. The contractor shall provide
monthly quality control reports and perform overall trending by
facility and contractor to the DOSDOS COR. All phases of food
service operations shall be evaluated against contractual
requirements. Provide monthly reports on QA/QC, inspection
findings and notification to DOS when follow-up action is needed,
or a health hazard is identified during data analysis.
12.2.1 Medical Evaluation of Food Service Employees
The Contractor shall ensure all Food Service personnel have
annual physicals, which will consist of, at minimum, of blood,
urine, and stool samples, laboratory testing, chest X-ray, TB
testing and HIV (AIDS) testing. The Contractor shall provide
copies of annual physical to the COR for record keeping.
The Contractor’s Food Service personnel who seek medical
treatment must be medically cleared prior to returning to work.
In the event there is a communicable disease, appropriate health
recommendations shall be elevated to COR who shall elevate to the
appropriate DOS personnel.
12.3 Reporting Plan
Performance Data System
The Contractor will keep COR informed of performance through
deliverables, reports, and regular meetings with the COR and Mess
NCO. The Contractor shall capture and record resource changes
against contract requirements to track schedules. Contractor
shall also monitor resource allocation and performance data to
determine whether sufficient resources are applied to required
tasks, or whether reductions in work warrant corresponding
reductions in staff. Analysis of labor, material, and equipment
expenditures to work order and job code levels enables the COR,
Mess NCO and Program manager to track key data to verify that
requirements are met to cost and schedule, and to identify and
correct variances. The Contractor shall coordinate with the COR
to enforce project controls at the site level. The Contractor’s
systems should be flexible, scalable, and adaptable to each
requirement offering DOS real-time performance data upon request
with minimal risk of information exposure.
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Business Systems
The Contractor’s business systems shall provide the support
structure needed to input and track data for Quality
Assurance/Quality Control (QA/QC) and performance management;
personnel management; contract management; and to share
deliverables and reports upon request.
The Contractor shall enhance program consistency, transparency,
and accountability by maintaining detailed, Government-recognized
processes and procedures for all MSG Detachment Cook duties.
These systems shall interface and feed information into a program
management information system to provide near real-time reporting
of performance status through a secure web-based portal/dashboard.
This portal integrates programs, systems, and plans, and
consolidates recruiting information, personnel management data,
time and labor tracking, cost, and performance data by scheduled
value. It shall provide a reporting mechanism to produce required
deliverables, personnel manning information, and employee
performance report status. The Contractor shall collaborate with
COR and identify specific needs from requirements regarding the
appropriate structuring and information needed for reporting.
Contractor reports are directly related to an approved invoice
system and human resource management system.
During performance, Contractor shall document work progress
against the schedule. The Contractor shall measure performance
against planned tasks weekly and monthly and develop a series of
schedule performance metrics. The Contractor shall submit reports
via electronic messaging to the COR, followed by hard copies as
requested.
12.4 Quality Control Plan
This plan provides an effective method to promote satisfactory
contractor performance. The QASP provides a method for the
Contracting Officer's Representative (COR) to monitor Contractor
performance, advise the Contractor of unsatisfactory performance,
and notify the Contracting Officer of continued unsatisfactory
performance. The Contractor, not the Government, is responsible
for management and quality control to meet the terms of the
contract. The role of the Government is to monitor quality to
ensure that contract standards are achieved.
Performance Objective Scope of Work
Para
Performance Threshold
Services.
Performs all cook
services set forth in
the scope of work,
Section 1.
Subsections 2
through 10.
All required services are
performed and no more
than:
(1) one customer complaint
is received per month.
(2) All required services
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are 90% adherence to
ServSafe quality standards
12.4.1 SURVEILLANCE. The COR will receive and document all
complaints from Government personnel regarding the services
provided. If appropriate, the COR will send the complaints to the
Contractor for corrective action.
12.4.2 STANDARD. The performance standard is that the Government
receives no more than one customer complaint per month. The COR
shall notify the Contracting Officer of the complaints so that the
Contracting Officer may take appropriate action to enforce the
inspection clause (FAR 52.212-4, Contract Terms and Conditions-
Commercial Items), if any of the services exceed the standard.
12.4.3 PROCEDURES
(a) If any Government personnel observe unacceptable services,
either incomplete work or required services not being performed
they should immediately contact the COR.
(b) The COR will complete appropriate documentation to record the
complaint.
(c) If the COR determines the complaint is invalid, the COR will
advise the complainant. The COR will retain the annotated copy
of the written complaint for his/her files.
(d) If the COR determines the complaint is valid, the COR will
inform the Contractor and give the Contractor additional time to
correct the defect, if additional time is available. The COR
shall determine how much time is reasonable.
(e) The COR shall, as a minimum, orally notify the Contractor of
any valid complaints.
(f) If the Contractor disagrees with the complaint after
investigation of the site and challenges the validity of the
complaint, the Contractor will notify the COR. The COR will
review the matter to determine the validity of the complaint.
(g) The COR will consider complaints as resolved unless notified
otherwise by the complainant.
(h) Repeat customer complaints are not permitted for any
services. If a repeat customer complaint is received for the
same deficiency during the service period, the COR will contact
the Contracting Officer for appropriate action under the
Inspection clause.
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Section 2: Contract Clauses
2.1 Contract Clauses
FAR 52.212-4 Contract Terms and Conditions – Commercial Items (OCT
2018) and (Deviation 2017-02) (June 2017), is incorporated by
reference (see SF-18, Block 11(b)).
“None”
FAR 52.212-5 Contract Terms and Conditions Required to Implement
Statutes or Executive Orders-Commercial Items (NOV 2020)
(a) The Contractor shall comply with the following Federal
Acquisition Regulation (FAR) clauses, which are incorporated in
this contract by reference, to implement provisions of law or
Executive orders applicable to acquisitions of commercial items:
(1) 52.203-19, Prohibition on Requiring Certain Internal
Confidentiality Agreements or Statements (Jan 2017) (section 743
of Division E, Title VII, of the Consolidated and Further
Continuing Appropriations Act, 2015 (Pub. L. 113-235) and its
successor provisions in subsequent appropriations acts (and as
extended in continuing resolutions)).
(2) 52.204-23, Prohibition on Contracting for Hardware, Software,
and Services Developed or Provided by Kaspersky Lab and Other
Covered Entities (JUL 2018) (Section 1634 of Pub. L. 115-91).
(3) 52.204-25, Prohibition on Contracting for Certain
Telecommunications and Video Surveillance Services or Equipment.
(AUG 2020) (Section 889(a)(1)(A) of Pub. L. 115-232).
(4) 52.209-10, Prohibition on Contracting with Inverted Domestic
Corporations (NOV 2015).
(5) 52.233-3, Protest After Award (AUG 1996) (31 U.S.C. 3553).
(6) 52.233-4, Applicable Law for Breach of Contract Claim (OCT
2004) (Public Laws 108-77 and 108-78 (19 U.S.C. 3805 note)).
(b) The Contractor shall comply with the FAR clauses in this
paragraph (b) that the Contracting Officer has indicated as being
incorporated in this contract by reference to implement provisions
of law or Executive orders applicable to acquisitions of
commercial items:
__ (1) 52.203-6, Restrictions on Subcontractor Sales to the
Government (JUNE 2020), with Alternate I (OCT 1995) (41
U.S.C. 4704 and 10 U.S.C. 2402).
__ (2) 52.203-13, Contractor Code of Business Ethics and Conduct
(JUN 2020) (41 U.S.C. 3509)).
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
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__ (3) 52.203-15, Whistleblower Protections under the American
Recovery and Reinvestment Act of 2009 (JUN 2010) (Section
1553 of Pub. L. 111-5). (Applies to contracts funded by
the American Recovery and Reinvestment Act of 2009.)
(4) 52.204-10, Reporting Executive Compensation and First-
Tier Subcontract Awards (JUN 2020) (Pub. L. 109-282) (31
U.S.C. 6101 note).
__ (5) [Reserved].
__ (6) 52.204-14, Service Contract Reporting Requirements (OCT
2016) (Pub. L. 111-117, section 743 of Div. C).
__ (7) 52.204-15, Service Contract Reporting Requirements for
Indefinite-Delivery Contracts (OCT 2016) (Pub. L. 111-117,
section 743 of Div. C).
(8) 52.209-6, Protecting the Government’s Interest When
Subcontracting with Contractors Debarred, Suspended, or
Proposed for Debarment. (JUN 2020) (31 U.S.C. 6101 note).
__ (9) 52.209-9, Updates of Publicly Available Information
Regarding Responsibility Matters (OCT 2018) (41 U.S.C.
2313).
__ (10) [Reserved].
__ (11) (i) 52.219-3, Notice of HUBZone Set-Aside or Sole-Source
Award (MAR 2020) (15 U.S.C. 657a).
__ (ii) Alternate I (MAR 2020) of 52.219-3.
__ (12) (i) 52.219-4, Notice of Price Evaluation Preference for
HUBZone Small Business Concerns (MAR 2020) (if the
offeror elects to waive the preference, it shall so
indicate in its offer) (15 U.S.C. 657a).
__ (ii) Alternate I (MAR 2020) of 52.219-4.
__ (13) [Reserved]
__ (14) (i) 52.219-6, Notice of Total Small Business Set-Aside
(NOV 2020) (15 U.S.C. 644).
__ (ii) Alternate I (MAR 2020) of 52.219-6.
__ (15) (i) 52.219-7, Notice of Partial Small Business Set-Aside
(NOV 2020) (15 U.S.C. 644).
__ (ii) Alternate I (MAR 2020) of 52.219-7.
__ (16) 52.219-8, Utilization of Small Business Concerns (OCT
2018) (15 U.S.C. 637(d)(2) and (3)).
__ (17) (i) 52.219-9, Small Business Subcontracting Plan (JUN
2020) (15 U.S.C. 637(d)(4)).
__ (ii) Alternate I (NOV 2016) of 52.219-9.
__ (iii) Alternate II (NOV 2016) of 52.219-9.
__ (iv) Alternate III (JUN 2020) of 52.219-9.
__ (v) Alternate IV (JUN 2020) of 52.219-9
__ (18) (i) 52.219-13, Notice of Set-Aside of Orders (MAR 2020)
(15 U.S.C. 644(r)).
__ (ii) Alternate I (MAR 2020) of 52.219-13.
__ (19) 52.219-14, Limitations on Subcontracting (MAR 2020) (15
U.S.C. 637(a)(14)).
__ (20) 52.219-16, Liquidated Damages-Subcontracting Plan (JAN
1999) (15 U.S.C. 637(d)(4)(F)(i)).
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
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__ (21) 52.219-27, Notice of Service-Disabled Veteran-Owned
Small Business Set-Aside (MAR 2020) (15 U.S.C. 657 f).
__ (22)(i) 52.219-28, Post Award Small Business Program
Representation (NOV 2020) (15 U.S.C. 632(a)(2)).
__ (ii) Alternate I (MAR 2020) of 52.219-28.
__ (23) 52.219-29, Notice of Set-Aside for, or Sole Source Award
to, Economically Disadvantaged Women-Owned Small Business
Concerns (MAR 2020) (15 U.S.C. 637(m)).
__ (24) 52.219-30, Notice of Set-Aside for, or Sole Source Award
to, Women-Owned Small Business Concerns Eligible Under
the Women-Owned Small Business Program (MAR 2020) (15
U.S.C. 637(m)).
__ (25) 52.219-32, Orders Issued Directly Under Small Business
Reserves (MAR 2020) (15 U.S.C. 644(r)).
__ (26) 52.219-33, Nonmanufacturer Rule (MAR 2020) (15 U.S.C.
637(a)(17)).
__ (27) 52.222-3, Convict Labor (JUN 2003) (E.O. 11755).
(28) 52.222-19, Child Labor. Cooperation with Authorities and
Remedies (JAN 2020) (E.O. 13126).
(29) 52.222-21, Prohibition of Segregated Facilities (APR
2015).
(30)(i) 52.222-26, Equal Opportunity (SEP 2016) (E.O. 11246).
__ (ii) Alternate I (FEB 1999) of 52.222-26.
__ (31)(i) 52.222-35, Equal Opportunity for Veterans (JUN
2020)(38 U.S.C. 4212).
__ (ii) Alternate I (JUL 2014) of 52.222-35.
__ (32)(i) 52.222-36, Equal Opportunity for Workers with
Disabilities (JUN 2020) (29 U.S.C. 793).
__ (ii) Alternate I (JUL 2014) of 52.222-36.
__ (33) 52.222-37, Employment Reports on Veterans (JUN 2020) (38
U.S.C. 4212).
__ (34) 52.222-40, Notification of Employee Rights Under the
National Labor Relations Act (DEC 2010) (E.O. 13496).
(35)(i) 52.222-50, Combating Trafficking in Persons (OCT
2020) (22 U.S.C. chapter 78 and E.O. 13627).
__ (ii) Alternate I (MAR 2015) of 52.222-50 (22 U.S.C.
chapter 78 and E.O. 13627).
__ (36) 52.222-54, Employment Eligibility Verification (OCT
2015). (Executive Order 12989). (Not applicable to the
acquisition of commercially available off-the-shelf items
or certain other types of commercial items as prescribed
in 22.1803.)
__ (37)(i) 52.223-9, Estimate of Percentage of Recovered
Material Content for EPA–Designated Items (MAY 2008) (42
U.S.C. 6962(c)(3)(A)(ii)). (Not applicable to the
acquisition of commercially available off-the-shelf
items.)
__ (ii) Alternate I (MAY 2008) of 52.223-9 (42 U.S.C.
6962(i)(2)(C)). (Not applicable to the acquisition of
commercially available off-the-shelf items.)
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
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__ (38) 52.223-11, Ozone-Depleting Substances and High Global
Warming Potential Hydrofluorocarbons (JUN 2016) (E.O.
13693).
__ (39) 52.223-12, Maintenance, Service, Repair, or Disposal of
Refrigeration Equipment and Air Conditioners (JUN 2016)
(E.O. 13693).
__ (40)(i) 52.223-13, Acquisition of EPEAT®-Registered Imaging
Equipment (JUN 2014) (E.O.s 13423 and 13514).
__ (ii) Alternate I (OCT 2015) of 52.223-13.
__ (41)(i) 52.223-14, Acquisition of EPEAT®-Registered
Televisions (JUN 2014) (E.O.s 13423 and 13514).
__ (ii) Alternate I (Jun 2014) of 52.223-14.
__ (42) 52.223-15, Energy Efficiency in Energy-Consuming
Products (MAY 2020) (42 U.S.C. 8259b).
__ (43)(i) 52.223-16, Acquisition of EPEAT®-Registered Personal
Computer Products (OCT 2015) (E.O.s 13423 and 13514).
__ (ii) Alternate I (JUN 2014) of 52.223-16.
(44) 52.223-18, Encouraging Contractor Policies to Ban Text
Messaging While Driving (JUN 2020) (E.O. 13513).
__ (45) 52.223-20, Aerosols (JUN 2016) (E.O. 13693).
__ (46) 52.223-21, Foams (JUN 2016) (E.O. 13693).
__ (47)(i) 52.224-3, Privacy Training (JAN 2017) (5 U.S.C. 552a).
__ (ii) Alternate I (JAN 2017) of 52.224-3.
__ (48) 52.225-1, Buy American-Supplies (MAY 2014) (41 U.S.C.
chapter 83).
__ (49)(i) 52.225-3, Buy American.Free Trade Agreements.Israeli
Trade Act (MAY 2014) (41 U.S.C. chapter 83, 19 U.S.C.
3301 note, 19 U.S.C. 2112 note, 19 U.S.C. 3805 note, 19
U.S.C. 4001 note, Pub. L. 103-182, 108-77, 108-78, 108-
286, 108-302, 109-53, 109-169, 109-283, 110-138, 112-41,
112-42, and 112-43.
__ (ii) Alternate I (MAY 2014) of 52.225-3.
__ (iii) Alternate II (MAY 2014) of 52.225-3.
__ (iv) Alternate III (MAY 2014) of 52.225-3.
__ (50) 52.225-5, Trade Agreements (Oct 2019) (19 U.S.C. 2501,
et seq., 19 U.S.C. 3301 note).
(51) 52.225-13, Restrictions on Certain Foreign Purchases
(JUN 2008) (E.O.’s, proclamations, and statutes
administered by the Office of Foreign Assets Control of
the Department of the Treasury).
__ (52) 52.225-26, Contractors Performing Private Security
Functions Outside the United States (OCT 2016) (Section
862, as amended, of the National Defense Authorization
Act for Fiscal Year 2008; 10 U.S.C. 2302 Note).
__ (53) 52.226-4, Notice of Disaster or Emergency Area Set-Aside
(NOV 2007) (42 U.S.C. 5150).
__ (54) 52.226-5, Restrictions on Subcontracting Outside
Disaster or Emergency Area (NOV 2007) (42 U.S.C. 5150).
__ (55) 52.229-12, Tax on Certain Foreign Procurements (JUN
2020).
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(56) 52.232-29, Terms for Financing of Purchases of
Commercial Items (FEB 2002) (41 U.S.C. 4505, 10 U.S.C.
2307(f)).
__ (57) 52.232-30, Installment Payments for Commercial Items
(JAN 2017) (41 U.S.C. 4505, 10 U.S.C. 2307(f)).
(58) 52.232-33, Payment by Electronic Funds Transfer-System
for Award Management (OCT 2018) (31 U.S.C. 3332).
__ (59) 52.232-34, Payment by Electronic Funds Transfer-Other
than System for Award Management (JUL 2013) (31 U.S.C.
3332).
__ (60) 52.232-36, Payment by Third Party (MAY 2014) (31 U.S.C.
3332).
__ (61) 52.239-1, Privacy or Security Safeguards (AUG 1996) (5
U.S.C. 552a).
__ (62) 52.242-5, Payments to Small Business Subcontractors (JAN
2017)(15 U.S.C. 637(d)(12)).
__ (63)(i) 52.247-64, Preference for Privately Owned U.S.-Flag
Commercial Vessels (FEB 2006) (46 U.S.C. Appx. 1241(b)
and 10 U.S.C. 2631).
__ (ii) Alternate I (APR 2003) of 52.247-64.
__ (iii) Alternate II (FEB 2006) of 52.247-64.
(c) The Contractor shall comply with the FAR clauses in this
paragraph (c), applicable to commercial services, that the
Contracting Officer has indicated as being incorporated in this
contract by reference to implement provisions of law or Executive
orders applicable to acquisitions of commercial items:
__ (1) 52.222-41, Service Contract Labor Standards (AUG 2018)
(41 U.S.C. chapter 67).
__ (2) 52.222-42, Statement of Equivalent Rates for Federal
Hires (MAY 2014) (29 U.S.C. 206 and 41 U.S.C. chapter 67).
__ (3) 52.222-43, Fair Labor Standards Act and Service Contract
Labor Standards-Price Adjustment (Multiple Year and
Option Contracts) (AUG 2018) (29 U.S.C. 206 and 41 U.S.C.
chapter 67).
__ (4) 52.222-44, Fair Labor Standards Act and Service Contract
Labor Standards.Price Adjustment (MAY 2014) (29 U.S.C.
206 and 41 U.S.C. chapter 67).
__ (5) 52.222-51, Exemption from Application of the Service
Contract Labor Standards to Contracts for Maintenance,
Calibration, or Repair of Certain Equipment-Requirements
(MAY 2014) (41 U.S.C. chapter 67).
__ (6) 52.222-53, Exemption from Application of the Service
Contract Labor Standards to Contracts for Certain
Services-Requirements (MAY 2014) (41 U.S.C. chapter 67).
__ (7) 52.222-55, Minimum Wages Under Executive Order 13658 (NOV
2020).
__ (8) 52.222-62, Paid Sick Leave Under Executive Order 13706
(JAN 2017) (E.O. 13706).
__ (9) 52.226-6, Promoting Excess Food Donation to Nonprofit
Organizations (JUN 2020) (42 U.S.C. 1792).
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(d) Comptroller General Examination of Record. The Contractor
shall comply with the provisions of this paragraph (d) if this
contract was awarded using other than sealed bid, is in excess of
the simplified acquisition threshold, as defined in FAR 2.101, on
the date of award of this contract, and does not contain the
clause at 52.215-2, Audit and Records-Negotiation.
(1) The Comptroller General of the United States, or an
authorized representative of the Comptroller General, shall have
access to and right to examine any of the Contractor’s directly
pertinent records involving transactions related to this contract.
(2) The Contractor shall make available at its offices at all
reasonable times the records, materials, and other evidence for
examination, audit, or reproduction, until 3 years after final
payment under this contract or for any shorter period specified
in FAR subpart 4.7, Contractor Records Retention, of the other
clauses of this contract. If this contract is completely or
partially terminated, the records relating to the work terminated
shall be made available for 3 years after any resulting final
termination settlement. Records relating to appeals under the
disputes clause or to litigation or the settlement of claims
arising under or relating to this contract shall be made
available until such appeals, litigation, or claims are finally
resolved.
(3) As used in this clause, records include books, documents,
accounting procedures and practices, and other data, regardless
of type and regardless of form. This does not require the
Contractor to create or maintain any record that the Contractor
does not maintain in the ordinary course of business or pursuant
to a provision of law.
(e)(1) Notwithstanding the requirements of the clauses in
paragraphs (a), (b), (c), and (d) of this clause, the Contractor
is not required to flow down any FAR clause, other than those in
this paragraph (e)(1) in a subcontract for commercial items.
Unless otherwise indicated below, the extent of the flow down
shall be as required by the clause.
(i) 52.203-13, Contractor Code of Business Ethics and Conduct
(JUN 2020) (41 U.S.C. 3509).
(ii) 52.203-19, Prohibition on Requiring Certain Internal
Confidentiality Agreements or Statements (JAN 2017) (section 743
of Division E, Title VII, of the Consolidated and Further
Continuing Appropriations Act, 2015 (Pub. L. 113-235) and its
successor provisions in subsequent appropriations acts (and as
extended in continuing resolutions)).
(iii) 52.204-23, Prohibition on Contracting for Hardware,
Software, and Services Developed or Provided by Kaspersky Lab
and Other Covered Entities (JUL 2018) (Section 1634 of Pub. L.
115-91).
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(iv) 52.204-25, Prohibition on Contracting for Certain
Telecommunications and Video Surveillance Services or Equipment.
(AUG 2020) (Section 889(a)(1)(A) of Pub. L. 115-232).
(v) 52.219-8, Utilization of Small Business Concerns (OCT 2018)
(15 U.S.C. 637(d)(2) and (3)), in all subcontracts that offer
further subcontracting opportunities. If the subcontract (except
subcontracts to small business concerns) exceeds $700,000 ($1.5
million for construction of any public facility), the
subcontractor must include 52.219-8 in lower tier subcontracts
that offer subcontracting opportunities.
(vi) 52.222-21, Prohibition of Segregated Facilities (APR 2015)
(vii) 52.222-26, Equal Opportunity (SEP 2015) (E.O. 11246).
(viii) 52.222-35, Equal Opportunity for Veterans (JUN 2020) (38
U.S.C. 4212).
(ix) 52.222-36, Equal Opportunity for Workers with Disabilities
(JUN 2020) (29 U.S.C. 793).
(x) 52.222-37, Employment Reports on Veterans (JUN 2020) (38
U.S.C. 4212)
(xi) 52.222-40, Notification of Employee Rights Under the
National Labor Relations Act (DEC 2010) (E.O. 13496). Flow down
required in accordance with paragraph (f) of FAR clause 52.222-
40.
(xii) 52.222-41, Service Contract Labor Standards (AUG 2018) (41
U.S.C. chapter 67).
(xiii)
__ (A) 52.222-50, Combating Trafficking in Persons (OCT 2020)
(22 U.S.C. chapter 78 and E.O 13627).
__ (B) Alternate I (MAR 2015) of 52.222-50 (22 U.S.C. chapter
78 and E.O 13627).
(xiv) 52.222-51, Exemption from Application of the Service
Contract Labor Standards to Contracts for Maintenance,
Calibration, or Repair of Certain Equipment-Requirements (MAY
2014) (41 U.S.C. chapter 67).
(xv) 52.222-53, Exemption from Application of the Service
Contract Labor Standards to Contracts for Certain Services-
Requirements (MAY 2014) (41 U.S.C. chapter 67).
(xvi) 52.222-54, Employment Eligibility Verification (OCT 2015)
(E.O. 12989).
(xvii) 52.222-55, Minimum Wages Under Executive Order 13658 (NOV
2020).
(xviii) 52.222-62, Paid Sick Leave Under Executive Order 13706
(JAN 2017) (E.O. 13706).
(xix)(A) 52.224-3, Privacy Training (JAN 2017) (5 U.S.C. 552a).
(B) Alternate I (JAN 2017) of 52.224-3.
(xx) 52.225-26, Contractors Performing Private Security
Functions Outside the United States (OCT 2016) (Section 862, as
amended, of the National Defense Authorization Act for Fiscal
Year 2008; 10 U.S.C. 2302 Note).
(xxi) 52.226-6, Promoting Excess Food Donation to Nonprofit
Organizations (JUN 2020) (42 U.S.C. 1792). Flow down required
in accordance with paragraph (e) of FAR clause 52.226-6.
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(xxii) 52.247-64, Preference for Privately Owned U.S.-Flag
Commercial Vessels (FEB 2006) (46 U.S.C. Appx. 1241(b) and 10
U.S.C. 2631). Flow down required in accordance with paragraph
(d) of FAR clause 52.247-64.
(2) While not required, the Contractor may include in its
subcontracts for commercial items a minimal number of additional
clauses necessary to satisfy its contractual obligations.
(End of clause)
Add the following clause in full text:
FAR 52.229-12 Tax on Certain Foreign Procurements (JUN 2020)
(a) Definitions. As used in this clause—
Foreign person means any person other than a United States person.
United States person, as defined in 26 U.S.C. 7701(a)(30), means—
(1) A citizen or resident of the United States;
(2) A domestic partnership;
(3) A domestic corporation;
(4) Any estate (other than a foreign estate, within the meaning
of 26 U.S.C. 7701(a)(31)); and
(5) Any trust if—
(i) A court within the United States is able to exercise primary
supervision over the administration of the trust; and
(ii) One or more United States persons have the authority to
control all substantial decisions of the trust.
(b) This clause applies only to foreign persons. It implements 26
U.S.C. 5000C and its implementing regulations at 26 CFR 1.5000C-1
through 1.5000C-7.
(c)(1) If the Contractor is a foreign person and has only a
partial or no exemption to the withholding, the Contractor shall
include the Department of the Treasury Internal Revenue Service
Form W-14, Certificate of Foreign Contracting Party Receiving
Federal Procurement Payments, with each voucher or invoice
submitted under this contract throughout the period in which this
status is applicable. The excise tax withholding is applied at
the payment level, not at the contract level. The Contractor
should revise each IRS Form W-14 submission to reflect the
exemption (if any) that applies to that particular invoice, such
as a different exemption applying. In the absence of a completed
IRS Form W-14 accompanying a payment request, the default
withholding percentage is 2 percent for the section 5000C
withholding for that payment request. Information about IRS Form
W-14 and its separate instructions is available via the internet
at www.irs.gov/w14.
(2) If the Contractor is a foreign person and has indicated in
its offer in the provision 52.229-11, Tax on Certain Foreign
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Procurements—Notice and Representation, that it is fully exempt
from the withholding, and certified the full exemption on the IRS
Form W-14, and if that full exemption no longer applies due to a
change in circumstances during the performance of the contract
that causes the Contractor to become subject to the withholding
for the 2 percent excise tax then the Contractor shall—
(i) Notify the Contracting Officer within 30 days of a change in
circumstances that causes the Contractor to be subject to the
excise tax withholding under 26 U.S.C. 5000C; and
(ii) Comply with paragraph (c)(1) of this clause.
(d) The Government will withhold a full 2 percent of each payment
unless the Contractor claims an exemption. If the Contractor
enters a ratio in Line 12 of the IRS Form W-14, the result of Line
11 divided by Line 10, the Government will withhold from each
payment an amount equal to 2 percent multiplied by the contract
ratio. If the Contractor marks box 9 of the IRS Form W-14 (rather
than completes Lines 10 through 12), 3ontractor must identify and
enter the specific exempt and nonexempt amounts in Line 15 of the
IRS Form W-14; the Government will then withhold 2 percent only
from the nonexempt amount. See the IRS Form W-14 and its
instructions.
(e) Exemptions from the withholding under this clause are
described at 26 CFR 1.5000C-1(d)(5) through (7). Any exemption
claimed and self-certified on the IRS Form W-14 is subject to
audit by the IRS. Any disputes regarding the imposition and
collection of the 26 U.S.C. 5000C tax are adjudicated by the IRS
as the 26 U.S.C. 5000C tax is a tax matter, not a contract issue.
(f) Taxes imposed under 26 U.S.C. 5000C may not be—
(1) Included in the contract price; nor
(2) Reimbursed.
(g) A taxpayer may, for a fee, seek advice from the Internal
Revenue Service (IRS) as to the proper tax treatment of a
transaction. This is called a private letter ruling. Also, the IRS
may publish a revenue ruling, which is an official interpretation
by the IRS of the Internal Revenue Code, related statutes, tax
treaties, and regulations. A revenue ruling is the conclusion of
the IRS on how the law is applied to a specific set of facts. For
questions relating to the interpretation of the IRS regulations go
to https://www.irs.gov/help/tax-law-questions.
(End of clause)
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2.2 Addendum to Contract Clauses – FAR and DOSAR Clauses not
Prescribed in Part 12
The following Federal Acquisition Regulation (FAR) clauses are
provided in full text:
FAR 52.252-2 Clauses Incorporated by Reference (FEB 1998)
This contract incorporates one or more clauses by reference, with
the same force and effect as if they were given in full text. Upon
request, the Contracting Officer will make their full text
available. In addition, the full text of a clause may be accessed
electronically at: https://acquisition.gov/browse/index/far this
address is subject to change.
If the Federal Acquisition Regulation (FAR) is not available at
the location indicated above, use the Department of State
Acquisition website at https://ecfr.io/cgi-bin/text-
idx?SID=d9a7851186785ba2b1896db79b1b6b29&mc=true&tpl=/ecfrbrowse/T
itle48/48tab_02.tpl to see the links to the FAR. You may also use
an Internet “search engine” (for example, Google, Yahoo or Excite)
to obtain the latest location of the most current FAR.
The following Federal Acquisition Regulation clauses are
incorporated by reference:
Clause Title and Date
52.203-17 Contractor Employee Whistleblower Rights and
Requirement to Inform Employees of Whistleblower Rights
(APR 2014)
52.203-19 Prohibition on Requiring Certain Internal
Confidentiality Agreements or Statements (JAN 2017)
52.204-9 Personal Identity Verification of Contractor Personnel
(JAN 2011)
52.204-12 Data Universal Numbering System Number Maintenance (DEC
2012)
52.204-13 System for Award Management Maintenance (OCT 2018)
52.204-18 Commercial and Government Entity Code Maintenance
(JUL 2016)
52.225-14 Inconsistency Between English Version and Translation
of Contract (FEB 2000)
52.228-3 Workers’ Compensation Insurance (Defense Base Act) (JUL
2014)
52.228-4 Worker’s Compensation and War-Hazard Insurance Overseas
(APR 1984)
52.228-5 Insurance – Work on a Government Installation (JAN
1997)
52.229-6 Foreign Fixed Price Contracts (FEB 2013)
52.232-39 Unenforceability of Unauthorized Obligations (JUNE
2013)
52.244-6 Subcontracts for Commercial Items (NOV 2020)
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The following FAR clauses are provided in full text:
FAR 52.217-8 Option to Extend Services (NOV 1999)
The Government may require continued performance of any services
within the limits and at the rates specified in the contract. The
option provision may be exercised more than once, but the total
extension of performance hereunder shall not exceed six months.
The Contracting Officer may exercise the option by written notice
to the Contractor within the performance period of the contract.
FAR 52.217-9 Option to Extend the Term of the Contract (MAR 2000)
(a) The Government may extend the term of this contract by written
notice to the Contractor within the performance period of the
contract or within 30 days after funds for the option year become
available, whichever is later.
(b) If the Government exercises this option, the extended contract
shall be considered to include this option clause.
(c) The total duration of this contract, including the exercise of
any options under this clause, shall not exceed five years.
FAR 52.232-19 Availability of Funds for the Next Fiscal Year (APR
1984)
Funds are not presently available for performance under this
contract beyond September 30th of the current calendar year. The
U.S. Government's obligation for performance of this contract
beyond that date is contingent upon the availability of
appropriated funds from which payment for contract purposes can be
made. No legal liability on the part of the Government for any
payment may arise for performance under this contract beyond
September 30th of the current calendar year, until funds are made
available to the Contracting Officer for performance and until the
Contractor receives notice of availability, to be confirmed in
writing by the Contracting Officer.
The following Department of State Acquisition Regulation (DOSAR)
clauses are provided in full text:
DOSAR 652.204-70 Department of State Personal Identification Card
Issuance (MAY 2011)
(a) The Contractor shall comply with the Department of State
(DOS) Personal Identification Card Issuance Procedures for all
employees performing under this contract who require frequent and
continuing access to DOS facilities, or information systems. The
Contractor shall insert this clause in all subcontracts when the
subcontractor’s employees will require frequent and continuing
access to DOS facilities, or information systems.
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(b) The DOS Personal Identification Card Issuance Procedures may
be accessed at http://www.state.gov/m/ds/rls/rpt/c21664.htm.
Contractor Identification (JULY 2008)
Contract performance may require contractor personnel to attend
meetings with government personnel and the public, work within
government offices, and/or utilize government email.
Contractor personnel must take the following actions to identify
themselves as non-federal employees:
(1) Use an email signature block that shows name, the office
being supported and company affiliation (e.g. “John Smith,
Office of Human Resources, ACME Corporation Support
Contractor”);
(2) Clearly identify themselves and their contractor affiliation
in meetings;
(3) Identify their contractor affiliation in Departmental e-mail
and phone listings whenever contractor personnel are included in
those listings; and
(4) Contractor personnel may not utilize Department of State
logos or indicia on business cards.
DOSAR 652.232-70 Payment Schedule and Invoice Submission (Fixed-
Price) (AUG 1999)
(a) General. The Government shall pay the Contractor as full
compensation for all work required, performed, and accepted under
this contract the firm fixed-price stated in this contract.
(b) Invoice Submission. The Contractor shall submit invoices in
one original to the office shown below. To constitute a proper
invoice, the invoice shall include all the items required by FAR
32.905(e).
Attn: Financial Management Center
U.S. Embassy Tokyo
(Invoice for PO# 19JA80-21-P-0307)
The Contractor may submit invoices electronically to
(c) Contractor Remittance Address. The Government will make
payment to the Contractor’s address stated on the cover page of
this contract, unless a separate remittance address is shown
below:
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(The U.S. Government will provide the winner of the contract
an electronic funds transfer (EFT) form to fill out.)
652.236-70 Additional Safety Measures (OCT 2017)
In addition to the safety/accident prevention requirements of FAR
52.236-13, Accident Prevention Alternate I, the contractor shall
comply with the following additional safety measures.
(a) High Risk Activities. If the project contains any of the
following high risk activities, the contractor shall follow the
section in the latest edition, as of the date of the
solicitation, of the U.S. Army Corps of Engineers Safety and
Health manual, EM 385 1 1, that corresponds to the high risk
activity. Before work may proceed, the contractor must obtain
approval from the COR of the written safety plan required by FAR
52.236-13, Accident Prevention Alternate I (see paragraph (f)
below), containing specific hazard mitigation and control
techniques.
(1) Scaffolding;
(2) Work at heights above 1.8 meters;
(3) Trenching or other excavation greater than one (1) meter
in depth;
(4) Earth-moving equipment and other large vehicles;
(5) Cranes and rigging;
(6) Welding or cutting and other hot work;
(7) Partial or total demolition of a structure;
(8) Temporary wiring, use of portable electric tools, or other
recognized electrical hazards. Temporary wiring and portable
electric tools require the use of a ground fault circuit
interrupter (GFCI) in the affected circuits; other electrical
hazards may also require the use of a GFCI;
(9) Work in confined spaces (limited exits, potential for
oxygen less than 19.5 percent or combustible atmosphere,
potential for solid or liquid engulfment, or other hazards
considered to be immediately dangerous to life or health such
as water tanks, transformer vaults, sewers, cisterns, etc.);
(10) Hazardous materials - a material with a physical or
health hazard including but not limited to, flammable,
explosive, corrosive, toxic, reactive or unstable, or any
operations, which creates any kind of contamination inside an
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
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occupied building such as dust from demolition activities,
paints, solvents, etc.; or
(11) Hazardous noise levels as required in EM 385-1 Section 5B
or local standards if more restrictive.
(b) Safety and Health Requirements. The contractor and all
subcontractors shall comply with the latest edition of the U.S.
Army Corps of Engineers Safety and Health manual EM 385-1-1, or
OSHA 29 CFR parts 1910 or 1926 if no EM 385-1-1 requirements are
applicable, and the accepted contractor’s written safety program.
(c) Mishap Reporting. The contractor is required to report
immediately all mishaps to the COR and the contracting officer.
A “mishap” is any event causing injury, disease or illness,
death, material loss or property damage, or incident causing
environmental contamination. The mishap reporting requirement
shall include fires, explosions, hazardous materials
contamination, and other similar incidents that may threaten
people, property, and equipment.
(d) Records. The contractor shall maintain an accurate record
on all mishaps incident to work performed under this contract
resulting in death, traumatic injury, occupational disease, or
damage to or theft of property, materials, supplies, or
equipment. The contractor shall report this data in the manner
prescribed by the contracting officer.
(e) Subcontracts. The contractor shall insert this clause,
including this paragraph (e), with appropriate changes in the
designation of the parties, in subcontracts.
(f) Written program. The plan required by paragraph (f)(1) of
the clause entitled “Accident Prevention Alternate I” shall be
known as the Site Safety and Health Plan (SSHP) and shall
address any activities listed in paragraph (a) of this clause,
or as otherwise required by the contracting officer/COR.
(1) The SSHP shall be submitted at least 10 working days prior
to commencing any activity at the site.
(2) The plan must address developing activity hazard analyses
(AHAs) for specific tasks. The AHAs shall define the
activities being performed and identify the work sequences,
the specific anticipated hazards, site conditions, equipment,
materials, and the control measures to be implemented to
eliminate or reduce each hazard to an acceptable level of risk.
Work shall not begin until the AHA for the work activity has
been accepted by the COR and discussed with all engaged in the
activity, including the Contractor, subcontractor(s), and
Government on-site representatives.
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(3) The names of the Competent/Qualified Person(s) required
for a particular activity (for example, excavations,
scaffolding, fall protection, other activities as specified by
EM 385 1 1) shall be identified and included in the AHA.
Proof of their competency/qualification shall be submitted to
the contracting officer or COR for acceptance prior to the
start of that work activity. The AHA shall be reviewed and
modified as necessary to address changing site conditions,
operations, or change of competent/qualified person(s).
(End of clause)
DOSAR 652.237-72 Observance of Legal Holidays and Administrative
Leave (FEB 2015)
(a) The Department of State observes the following days as
holidays:
New Year’s Day
Martin Luther King’s Birthday
Washington’s Birthday
Memorial Day
Independence Day
Labor Day
Columbus Day
Veterans Day
Thanksgiving Day
Christmas Day
Any other day designated by Federal law, Executive Order, or
Presidential Proclamation.
(b) When New Year’s Day, Independence Day, Veterans Day or
Christmas Day falls on a Sunday, the following Monday is
observed; if it falls on Saturday the preceding Friday is
observed. Observance of such days by Government personnel shall
not be cause for additional period of performance or entitlement
to compensation except as set forth in the contract. If the
contractor’s personnel work on a holiday, no form of holiday or
other premium compensation will be reimbursed either as a direct
or indirect cost, unless authorized pursuant to an overtime
clause elsewhere in this contract.
(c) When the Department of State grants administrative leave to
its Government employees, assigned contractor personnel in
Government facilities shall also be dismissed. However, the
contractor agrees to continue to provide sufficient personnel to
perform round-the-clock requirements of critical tasks already in
operation or scheduled, and shall be guided by the instructions
issued by the contracting officer or his/her duly authorized
representative.
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(d) For fixed-price contracts, if services are not required or
provided because the building is closed due to inclement weather,
unanticipated holidays declared by the President, failure of
Congress to appropriate funds, or similar reasons, deductions
will be computed as follows:
(1) The deduction rate in dollars per day will be equal to the
per month contract price divided by 21 days per month.
(2) The deduction rate in dollars per day will be multiplied by
the number of days services are not required or provided.
If services are provided for portions of days, appropriate
adjustment will be made by the contracting officer to ensure that
the contractor is compensated for services provided.
(e) If administrative leave is granted to contractor personnel as
a result of conditions stipulated in any “Excusable Delays”
clause of this contract, it will be without loss to the
contractor. The cost of salaries and wages to the contractor for
the period of any such excused absence shall be a reimbursable
item of direct cost hereunder for employees whose regular time is
normally charged, and a reimbursable item of indirect cost for
employees whose time is normally charged indirectly in accordance
with the contractors accounting policy.
(End of clause)
See the Attachment 3 - Japanese Holidays during Year 2021
DOSAR 652.242-70 Contracting Officer’s Representative (COR) (AUG
1999)
(a) The Contracting Officer may designate in writing one or more
Government employees, by name or position title, to take action
for the Contracting Officer under this contract. Each designee
shall be identified as a Contracting Officer’s Representative
(COR). Such designation(s) shall specify the scope and
limitations of the authority so delegated; provided, that the
designee shall not change the terms or conditions of the contract,
unless the COR is a warranted Contracting Officer and this
authority is delegated in the designation.
(b) The COR for this contract is Marine Security Guard at the U.S.
Embassy Tokyo.
DOSAR 652.242-73 Authorization and Performance (AUG 1999)
(a) The Contractor warrants the following:
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
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(1) That is has obtained authorization to operate and do
business in the country or countries in which this contract will
be performed;
(2) That is has obtained all necessary licenses and permits
required to perform this contract; and
(3) That it shall comply fully with all laws, decrees, labor
standards, and regulations of said country or countries during
the performance of this contract.
(b) If the party actually performing the work will be a
subcontractor or joint venture partner, then such subcontractor
or joint venture partner agrees to the requirements of paragraph
(a) of this clause.
DOSAR 652.229-70 Excise Tax Exemption Statement for Contractors
within the United States (JUL 1988)
This is to certify that the item(s) covered by this contract
is/are for export solely for the use of the U.S. Foreign Service
Post identified in the contract schedule.
The Contractor shall use a photocopy of this contract as evidence
of intent to export. Final proof of exportation may be obtained
from the agent handling the shipment. Such proof shall be
accepted in lieu of payment of excise tax.
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Section 3: Solicitation Provisions
3.1. Solicitation Provisions
3.1.1 (a) FAR 52.212-1, Instructions to Offerors - Commercial Items
(JUN 2020), is incorporated by reference. (see SF-18, Block (b))
Addendum to 52.212-1: none
3.2 Summary of Instructions
The quoter shall complete and submit one copy of the following:
(a) Volume 1 – Standard Form 18 (SF-18). Volume 1 consists of
completion of blocks 13, 14, 15, and 16 of the form (page 1);
(b) Volume 2 - Price. Volume 2 consists of Section 1.1.3: Price
(page 3) of the RFQ, and Price breakdown. Quoters must include
the currency which they are submitting their prices in.
(c) Volume 3 - Representations and Certifications. Volume 3
consists of Section 5: Representations and Certifications
(complete all portions that are applicable) of RFQ.
(d) Volume 4 – Technical Proposals. Volume 4 consists of
information demonstrating the quoter’s ability to perform,
including:
(1) Name of a Representative/Supervisor and resume detailing
background and at least 3 years of experience in nutrition and
managing food service operation at the premium level and who
understand written and spoken English at Level 3 of Attachment 4
- English Speaking Levels;
(2) Name of the Primary MSG Cook and resume detailing (1) a
minimum of 5 years’ experience managing food services operations
demonstrating experience in premium level food and service
execution (2) understanding written and spoken English at Level 2
of Attachment 4 - English Speaking Levels and (3) license in food
operation. Resumes of personnel not currently employed by the
Contractor must contain a statement that use of their resume for
this solicitation is authorized;
(3) Name of up to two (2) alternatve cooks and resume detailing –
(a) a minimum of 1 years of experience managing food service
operations demonstrating experience in premium level food and
service execution;
(b) understanding written and spoken English at Level 2 of
Attachment 4 – English Speaking Levels; and
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
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(c) license in food preparation. Resumes of personnel not
currently employed by the Contractor must contain a statement
that use of their resume for this solicitation is authorized.
(4) Evidence that the offeror/quoter operates an established
business with a permanent address and telephone listing and a
valid food service operating license;
(5) List of clients over the past 15 years, demonstrating prior
experience with food preparation, serving and relevant past
performance information and references (provide dates of
contracts, places of performance, value of contracts, contact
names, telephone and fax numbers and email addresses). If the
offeror has not performed comparable services in Japan, then the
offeror shall provide its international experience. Offerors are
advised that the past performance information requested above may
be discussed with the client’s contact person. In addition, the
client’s contact person may be asked to comment on the offeror’s:
Quality of services provided under the contract;
Compliance with contract terms and conditions;
Effectiveness of management;
Willingness to cooperate with and assist the customer in
routine matters, and when confronted by unexpected
difficulties; and
Business integrity / business conduct.
The Government will use past performance information primarily to
assess a quoter’s capability to meet the solicitation performance
requirements, including the relevance and successful performance
of the quoter’s work experience. The Government may also use
this data to evaluate the credibility of the quoter’s proposal.
In addition, the Contracting Officer may use past performance
information in making a determination of responsibility.
(1) Evidence that the offeror/quoter can provide the necessary personnel, equipment, and financial resources needed to
perform the work;
(2) The Offeror shall address its plan to obtain all licenses and permits required by local law (see DOSAR 652.242-73 in
Section 2). If offeror already possesses the locally
required licenses and permits, a copy shall be provided.
(3) The offeror’s strategic plan for cook services to include but not limited to:
(a) A work plan taking into account all work elements in Section 1, Performance Work Statement.
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
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(b) Identify types and quantities of equipment, supplies and materials required for performance of services under this
contract. Identify if the offeror already possesses the
listed items and their condition for suitability and if
not already possessed or inadequate for use how and when
the items will be obtained;
(c) Plan of ensuring quality of services including but not
limited to contract administration and oversight to
include Risk Management Plan, Reporting plan, Hazard
Analysis Critical Point Plan, HACCP taking in to account
all Deliverables listed in Attachment 1 Deliverables; and
(d) (1) If insurance is required by the solicitation, a copy
of the Certificate of Insurance(s), or
(2) a statement that the Contractor will get the required
insurance, and the name of the insurance provider to be
used.
Quotation must be received no later than 12:00 noon, Wednesday,
March 24, 2021 (Japan Standard Time) via email shown below. (Not via
Postal Mail)
No quotations will be accepted after this time.
Point of Contact: Masao Chuma – Procurement Agent
Email: [email protected]
Subject: RFQ 19JA80-21-Q-0307
Mobile: 090-1110-9306
Embassy Telephone Operator: 03-3224-5000
* After submitted of quotation, quoter shall contact Masao Chuma by
phone or separate email to confirm the receipt of quotation.
The quoter shall identify and explain/justify any deviations,
exceptions, or conditional assumptions taken with respect to any of
the instructions or requirements of this RFQ in the appropriate
volume of the quote.
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
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3.3 Addendum to Solicitation Provisions – FAR and DOSAR Provisions
not Prescribed in Part 12
FAR 52.252-1 Solicitation Provisions Incorporated by Reference (FEB
1998)
This solicitation incorporates one or more solicitation provisions
by reference, with the same force and effect as if they were given
in full text. Upon request, the Contracting Officer will make
their full text available. In addition, the full text of a clause
may be accessed electronically at Acquisition.gov this address is
subject to change.
If the Federal Acquisition Regulation (FAR) is not available at
the location indicated above, use the Department of State
Acquisition website at e-CFR to see the links to the FAR. You may
also use an Internet “search engine” (for example, Google, Yahoo
or Excite) to obtain the latest location of the most current FAR.
The following Federal Acquisition Regulation (FAR) solicitation
provisions are incorporated by reference:
Provision Title and Date
52.204-7 System for Award Management (OCT 2018)
52.204-16 Commercial and Government Entity Code Reporting (JUL
2016)
52.214-34 Submission of Offers in the English Language (APR
1991)
52.237-1 Site Visit (APR 1984)
The site visit will be held on March 10, 2021 at 10:00 a.m.
(Japan Standard Time) at the U.S. Embassy Apartment Compound, 2-
1-1 Roppongi, Minato-ku, Tokyo 106-0032. Prospective
offerors/quoters should contact Masao Chuma by email at
[email protected] for additional information to arrange entry to
the Compound.
The following Department of State Acquisition Regulation (DOSAR)
provision is provided in full text:
DOSAR 652.206-70 Advocate for Competition/Ombudsman (FEB 2015)
(a) The Department of State’s Advocate for Competition is
responsible for assisting industry in removing restrictive
requirements from Department of State solicitations and removing
barriers to full and open competition and use of commercial items.
If such a solicitation is considered competitively restrictive or
does not appear properly conducive to competition and commercial
practices, potential offerors are encouraged first to contact the
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
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contracting office for the solicitation. If concerns remain
unresolved, contact:
(1) For solicitations issued by the Office of Acquisition
Management (A/LM/AQM) or a Regional Procurement Support Office,
the A/LM/AQM Advocate for Competition, at
(2) For all others, the Department of State Advocate for
Competition at [email protected].
(b) The Department of State’s Acquisition Ombudsman has been
appointed to hear concerns from potential offerors and contractors
during the pre-award and post-award phases of this acquisition.
The role of the ombudsman is not to diminish the authority of the
contracting officer, the Technical Evaluation Panel or Source
Evaluation Board, or the selection official. The purpose of the
ombudsman is to facilitate the communication of concerns, issues,
disagreements, and recommendations of interested parties to the
appropriate Government personnel, and work to resolve them. When
requested and appropriate, the ombudsman will maintain strict
confidentiality as to the source of the concern. The ombudsman
does not participate in the evaluation of proposals, the source
selection process, or the adjudication of formal contract disputes.
Interested parties are invited to contact the contracting activity
ombudsman, Minister-Counselor for Management Affairs, at TEL: +81-
3-3224-5585 or FAX: +81-3-3224-5303. For an American Embassy or
overseas post, refer to the numbers below for the Department
Acquisition Ombudsman. Concerns, issues, disagreements, and
recommendations which cannot be resolved at a contracting activity
level may be referred to the Department of State Acquisition
Ombudsman at (703) 516-1696 or write to:
Department of State
Acquisition Ombudsman
Office of the Procurement Executive (A/OPE)
Suite 1060, SA-15
Washington, DC 20520
U.S.A.
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
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Section 4: Evaluation Factors
4.1 Evaluation Factors
The U.S. Government intends to award a contract resulting from this
Request for Quotations (RFQ) to the lowest priced, technically
acceptable, responsible offeror. The evaluation process shall
include the following:
(a) Award will be made to the lowest priced, technically
acceptable, responsible offeror. The U.S. Government reserves the
right to reject proposals that are unreasonably low or high in
price.
(b) The lowest price will be determined by multiplying the offered
prices times the estimated quantities in “1.1.3 Prices -
Continuation of SF-18, block 11(f), Amount”, and arriving at a
grand total, including all options.
(c) The Government will determine acceptability by assessing the
offeror's compliance with the terms of the RFQ to include the
technical information required by Section 3.
(d) The Government will determine contractor responsibility by
analyzing whether the apparent successful quoter complies with the
requirements of FAR 9.1, including:
(1) Adequate financial resources or the ability to obtain them;
(2) Ability to comply with the required performance period,
taking into consideration all existing commercial and
governmental business commitments;
(3) Satisfactory record of integrity and business ethics;
(4) Necessary organization, experience, and skills or the ability
to obtain them;
(5) Necessary equipment and facilities or the ability to obtain
them;
(6) Be otherwise qualified and eligible to receive an award under
applicable laws and regulations; and
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4.2 Addendum to Evaluation Factors – FAR and DOSAR Provisions not
Prescribed in Part 12
The following Federal Acquisition Regulation (FAR) provisions are
provided in full text:
FAR 52.217 5 Evaluation of Options (JUL 1990)
The Government will evaluate offers for award purposes by adding
the total price for all options to the total price for the basic
requirement. Evaluation of options will not obligate the
Government to exercise the option(s).
(End of clause)
FAR 52.225-17 Evaluation of Foreign Currency Offers (FEB 2000)
If the Government receives offers in more than one currency, the
Government will evaluate offers by converting the foreign
currency to United States currency using the exchange rate used
by the Embassy in effect as follows:
(a) For acquisitions conducted using sealed bidding procedures,
on the date of bid opening.
(b) For acquisitions conducted using negotiation procedures—
(1) On the date specified for receipt of offers, if award is
based on initial offers; otherwise
(2) On the date specified for receipt of proposal revisions.
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Section 5: Representations and Certifications
5.1 Offeror Representations and Certifications
FAR 52.212-3 Offeror Representations and Certifications - Commercial
Item (FEB 2021)
The Offeror shall complete only paragraph (b) of this provision if
the Offeror has completed the annual representations and
certification electronically in the System for Award Management
(SAM) accessed through https://www.sam.gov. If the Offeror has
not completed the annual representations and certifications
electronically, the Offeror shall complete only paragraphs (c)
through (v) of this provision.
(a) Definitions. As used in this provision—
“Covered telecommunications equipment or services” has the
meaning provided in the clause 52.204-25, Prohibition on
Contracting for Certain Telecommunications and Video
Surveillance Services or Equipment.
“Economically disadvantaged women-owned small business (EDWOSB)
concern” means a small business concern that is at least 51
percent directly and unconditionally owned by, and the
management and daily business operations of which are controlled
by, one or more women who are citizens of the United States and
who are economically disadvantaged in accordance with 13 CFR
part 127. It automatically qualifies as a women-owned small
business eligible under the WOSB Program.
“Forced or indentured child labor” means all work or service—
(1) Exacted from any person under the age of 18 under the
menace of any penalty for its nonperformance and for which the
worker does not offer himself voluntarily; or
(2) Performed by any person under the age of 18 pursuant to a
contract the enforcement of which can be accomplished by
process or penalties.
“Highest-level owner” means the entity that owns or controls an
immediate owner of the offeror, or that owns or controls one or
more entities that control an immediate owner of the offeror. No
entity owns or exercises control of the highest level owner.
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“Immediate owner” means an entity, other than the offeror, that
has direct control of the offeror. Indicators of control include,
but are not limited to, one or more of the following: ownership
or interlocking management, identity of interests among family
members, shared facilities and equipment, and the common use of
employees.
“Inverted domestic corporation”, means a foreign incorporated
entity that meets the definition of an inverted domestic
corporation under 6 U.S.C. 395(b), applied in accordance with
the rules and definitions of 6 U.S.C. 395(c)
“Manufactured end product” means any end product in product and
service codes (PSCs) 1000-9999, except—
(1) PSC 5510, Lumber and Related Basic Wood Materials;
(2) Product or Service Group (PSG) 87, Agricultural Supplies;
(3) PSG 88, Live Animals;
(4) PSG 89, Subsistence;
(5) PSC 9410, Crude Grades of Plant Materials;
(6) PSC 9430, Miscellaneous Crude Animal Products, Inedible;
(7) PSC 9440, Miscellaneous Crude Agricultural and Forestry
Products;
(8) PSC 9610, Ores;
(9) PSC 9620, Minerals, Natural and Synthetic; and
(10) PSC 9630, Additive Metal Materials.
“Place of manufacture” means the place where an end product is
assembled out of components, or otherwise made or processed from
raw materials into the finished product that is to be provided
to the Government. If a product is disassembled and reassembled,
the place of reassembly is not the place of manufacture.
“Predecessor” means an entity that is replaced by a successor
and includes any predecessors of the predecessor.
“Restricted business operations” means business operations in
Sudan that include power production activities, mineral
extraction activities, oil-related activities, or the production
of military equipment, as those terms are defined in the Sudan
Accountability and Divestment Act of 2007 (Pub. L. 110-174).
Restricted business operations do not include business
operations that the person (as that term is defined in Section 2
of the Sudan Accountability and Divestment Act of 2007)
conducting the business can demonstrate—
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
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(1) Are conducted under contract directly and exclusively with
the regional government of southern Sudan;
(2) Are conducted pursuant to specific authorization from the
Office of Foreign Assets Control in the Department of the
Treasury, or are expressly exempted under Federal law from the
requirement to be conducted under such authorization;
(3) Consist of providing goods or services to marginalized
populations of Sudan;
(4) Consist of providing goods or services to an
internationally recognized peacekeeping force or humanitarian
organization;
(5) Consist of providing goods or services that are used only
to promote health or education; or
(6) Have been voluntarily suspended.
“Sensitive technology”—
(1) Means hardware, software, telecommunications equipment, or
any other technology that is to be used specifically—
(i) To restrict the free flow of unbiased information in
Iran; or
(ii) To disrupt, monitor, or otherwise restrict speech of the
people of Iran; and
(2) Does not include information or informational materials
the export of which the President does not have the authority
to regulate or prohibit pursuant to section 203(b)(3) of the
International Emergency Economic Powers Act (50 U.S.C.
1702(b)(3)).
“Service-disabled veteran-owned small business concern”—
(1) Means a small business concern—
(i) Not less than 51 percent of which is owned by one or more
service-disabled veterans or, in the case of any publicly
owned business, not less than 51 percent of the stock of
which is owned by one or more service-disabled veterans; and
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(ii) The management and daily business operations of which
are controlled by one or more service-disabled veterans or,
in the case of a service-disabled veteran with permanent and
severe disability, the spouse or permanent caregiver of such
veteran.
(2) Service-disabled veteran means a veteran, as defined in 38
U.S.C. 101(2), with a disability that is service-connected, as
defined in 38 U.S.C. 101(16).
“Small business concern”-
(1) Means a concern, including its affiliates, that is
independently owned and operated, not dominant in the field of
operation in which it is bidding on Government contracts, and
qualified as a small business under the criteria in 13 CFR
part 121 and size standards in this solicitation.
(2) Affiliates, as used in this definition, means business
concerns, one of whom directly or indirectly controls or has
the power to control the others, or a third party or parties
control or have the power to control the others. In
determining whether affiliation exists, consideration is given
to all appropriate factors including common ownership, common
management, and contractual relationships. SBA determines
affiliation based on the factors set forth at 13 CFR 121.103.
“Small disadvantaged business concern”, consistent with 13 CFR
124.1002, means a small business concern under the size standard
applicable to the acquisition, that—
(1) Is at least 51 percent unconditionally and directly owned
(as defined at 13 CFR 124.105) by—
(i) One or more socially disadvantaged (as defined at 13 CFR
124.103) and economically disadvantaged (as defined at 13 CFR
124.104) individuals who are citizens of the United States;
and
(ii) Each individual claiming economic disadvantage has a net
worth not exceeding $750,000 after taking into account the
applicable exclusions set forth at 13 CFR 124.104(c)(2); and
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
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(2) The management and daily business operations of which are
controlled (as defined at 13.CFR 124.106) by individuals, who
meet the criteria in paragraphs (1)(i) and (ii) of this
definition.
“Subsidiary” means an entity in which more than 50 percent of
the entity is owned—
(1) Directly by a parent corporation; or
(2) Through another subsidiary of a parent corporation.
“Successor” means an entity that has replaced a predecessor by
acquiring the assets and carrying out the affairs of the
predecessor under a new name (often through acquisition or
merger). The term “successor” does not include new
offices/divisions of the same company or a company that only
changes its name. The extent of the responsibility of the
successor for the liabilities of the predecessor may vary,
depending on State law and specific circumstances.
“Veteran-owned small business concern” means a small business
concern—
(1) Not less than 51 percent of which is owned by one or more
veterans (as defined at 38 U.S.C. 101(2)) or, in the case of
any publicly owned business, not less than 51 percent of the
stock of which is owned by one or more veterans; and
(2) The management and daily business operations of which are
controlled by one or more veterans.
“Women-owned small business (WOSB) concern eligible under the
WOSB Program” (in accordance with 13 CFR part127), means a small
business concern that is at least 51 percent directly and
unconditionally owned by, and the management and daily business
operations of which are controlled by, one or more women who are
citizens of the United States.
“Women-owned small business concern” means a small business
concern—
(1) That is at least 51 percent owned by one or more women; or,
in the case of any publicly owned business, at least 51
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
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percent of the stock of which is owned by one or more women;
and
(2) Whose management and daily business operations are
controlled by one or more women.
(b)
(1) Annual Representations and Certifications. Any changes
provided by the Offeror in paragraph (b)(2) of this provision
do not automatically change the representations and
certifications in SAM.
(2) The offeror has completed the annual representations and
certifications electronically in SAM accessed through
http://www.sam.gov. After reviewing SAM information, the
Offeror verifies by submission of this offer that the
representations and certifications currently posted
electronically at FAR 52.212-3, Offeror Representations and
Certifications-Commercial Items, have been entered or updated
in the last 12 months, are current, accurate, complete, and
applicable to this solicitation (including the business size
standard applicable to the NAICS code referenced for this
solicitation), at the time this offer is submitted and are
incorporated in this offer by reference (see FAR 4.1201),
except for paragraphs ___________.
[Offeror to identify the applicable paragraphs at (c) through (v)
of this provision that the offeror has completed for the purposes
of this solicitation only, if any.
These amended representation(s) and/or certification(s) are also
incorporated in this offer and are current, accurate, and
complete as of the date of this offer.
Any changes provided by the offeror are applicable to this
solicitation only, and do not result in an update to the
representations and certifications posted electronically on SAM.]
(c) Reserved.
(d) Reserved.
(e) Certification Regarding Payments to Influence Federal
Transactions (31 U.S.C. 1352). (Applies only if the contract is
expected to exceed $150,000.) By submission of its offer, the
offeror certifies to the best of its knowledge and belief that no
Federal appropriated funds have been paid or will be paid to any
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
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person for influencing or attempting to influence an officer or
employee of any agency, a Member of Congress, an officer or
employee of Congress or an employee of a Member of Congress on
his or her behalf in connection with the award of any resultant
contract. If any registrants under the Lobbying Disclosure Act
of 1995 have made a lobbying contact on behalf of the offeror
with respect to this contract, the offeror shall complete and
submit, with its offer, OMB Standard Form LLL, Disclosure of
Lobbying Activities, to provide the name of the registrants. The
offeror need not report regularly employed officers or employees
of the offeror to whom payments of reasonable compensation were
made.
(f) Reserved.
(g) Reserved.
(h) Certification Regarding Responsibility Matters (Executive
Order 12689). (Applies only if the contract value is expected to
exceed the simplified acquisition threshold.) The offeror
certifies, to the best of its knowledge and belief, that the
offeror and/or any of its principals—
(1) □ Are, □ are not presently debarred, suspended, proposed for
debarment, or declared ineligible for the award of contracts by
any Federal agency;
(2) □ Have, □ have not, within a three-year period preceding
this offer, been convicted of or had a civil judgment rendered
against them for: commission of fraud or a criminal offense in
connection with obtaining, attempting to obtain, or performing a
Federal, state or local government contract or subcontract;
violation of Federal or state antitrust statutes relating to the
submission of offers; or commission of embezzlement, theft,
forgery, bribery, falsification or destruction of records,
making false statements, tax evasion, violating Federal criminal
tax laws, or receiving stolen property;
(3) □ Are, □ are not presently indicted for, or otherwise
criminally or civilly charged by a Government entity with,
commission of any of these offenses enumerated in paragraph
(h)(2) of this clause; and
(4) □ Have, □ have not, within a three-year period preceding
this offer, been notified of any delinquent Federal taxes in an
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
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amount that exceeds $3,500 for which the liability remains
unsatisfied.
(i) Taxes are considered delinquent if both of the following
criteria apply:
(A) The tax liability is finally determined. The liability is
finally determined if it has been assessed. A liability is
not finally determined if there is a pending administrative
or judicial challenge. In the case of a judicial challenge to
the liability, the liability is not finally determined until
all judicial appeal rights have been exhausted.
(B) The taxpayer is delinquent in making payment. A taxpayer
is delinquent if the taxpayer has failed to pay the tax
liability when full payment was due and required. A taxpayer
is not delinquent in cases where enforced collection action
is precluded.
(ii) Examples.
(A) The taxpayer has received a statutory notice of
deficiency, under I.R.C. §6212, which entitles the taxpayer
to seek Tax Court review of a proposed tax deficiency. This
is not a delinquent tax because it is not a final tax
liability. Should the taxpayer seek Tax Court review, this
will not be a final tax liability until the taxpayer has
exercised all judicial appeal rights.
(B) The IRS has filed a notice of Federal tax lien with
respect to an assessed tax liability, and the taxpayer has
been issued a notice under I.R.C. §6320 entitling the
taxpayer to request a hearing with the IRS Office of Appeals
contesting the lien filing, and to further appeal to the Tax
Court if the IRS determines to sustain the lien filing. In
the course of the hearing, the taxpayer is entitled to
contest the underlying tax liability because the taxpayer has
had no prior opportunity to contest the liability. This is
not a delinquent tax because it is not a final tax liability.
Should the taxpayer seek tax court review, this will not be a
final tax liability until the taxpayer has exercised all
judicial appeal rights.
(C) The taxpayer has entered into an installment agreement
pursuant to I.R.C. §6159. The taxpayer is making timely
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payments and is in full compliance with the agreement terms.
The taxpayer is not delinquent because the taxpayer is not
currently required to make full payment.
(D) The taxpayer has filed for bankruptcy protection. The
taxpayer is not delinquent because enforced collection action
is stayed under 11 U.S.C. §362 (the Bankruptcy Code).
(i) Certification Regarding Knowledge of Child Labor for Listed
End Products (Executive Order 13126). [The Contracting Officer
must list in paragraph (i)(1) any end products being acquired
under this solicitation that are included in the List of Products
Requiring Contractor Certification as to Forced or Indentured
Child Labor, unless excluded at 22.1503(b).]
(1) Listed end products.
Listed End Product Listed Countries of Origin
___________________ ___________________
___________________ ___________________
(2) Certification. [If the Contracting Officer has identified
end products and countries of origin in paragraph (i)(1) of this
provision, then the offeror must certify to either (i)(2)(i) or
(i)(2)(ii) by checking the appropriate block.]
□ (i) The offeror will not supply any end product listed in
paragraph (i)(1) of this provision that was mined, produced,
or manufactured in the corresponding country as listed for
that product.
□ (ii) The offeror may supply an end product listed in
paragraph (i)(1) of this provision that was mined, produced,
or manufactured in the corresponding country as listed for
that product. The offeror certifies that it has made a good
faith effort to determine whether forced or indentured child
labor was used to mine, produce, or manufacture any such end
product furnished under this contract. On the basis of those
efforts, the offeror certifies that it is not aware of any
such use of child labor.
(j) Reserved.
(k) Certificates regarding exemptions from the application of the
Service Contract Labor Standards (Certification by the offeror as
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
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to its compliance with respect to the contract also constitutes
its certification as to compliance by its subcontractor if it
subcontracts out the exempt services.) [The contracting officer
is to check a box to indicate if paragraph (k)(1) or (k)(2)
applies.]
□ (1) Maintenance, calibration, or repair of certain equipment
as described in FAR 22.1003-4(c)(1). The offeror □ does □ does
not certify that—
(i) The items of equipment to be serviced under this contract
are used regularly for other than Governmental purposes and
are sold or traded by the offeror (or subcontractor in the
case of an exempt subcontract) in substantial quantities to
the general public in the course of normal business
operations;
(ii) The services will be furnished at prices which are, or
are based on, established catalog or market prices (see
FAR 22.1003-4(c)(2)(ii)) for the maintenance, calibration, or
repair of such equipment; and
(iii) The compensation (wage and fringe benefits) plan for all
service employees performing work under the contract will be
the same as that used for these employees and equivalent
employees servicing the same equipment of commercial customers.
□ (2) Certain services as described in FAR 22.1003-4(d)(1). The
offeror □ does □ does not certify that—
(i) The services under the contract are offered and sold
regularly to non-Governmental customers, and are provided by
the offeror (or subcontractor in the case of an exempt
subcontract) to the general public in substantial quantities
in the course of normal business operations;
(ii) The contract services will be furnished at prices that
are, or are based on, established catalog or market prices
(see FAR 22.1003-4(d)(2)(iii));
(iii) Each service employee who will perform the services
under the contract will spend only a small portion of his or
her time (a monthly average of less than 20 percent of the
available hours on an annualized basis, or less than 20
percent of available hours during the contract period if the
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
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contract period is less than a month) servicing the Government
contract; and
(iv) The compensation (wage and fringe benefits) plan for all
service employees performing work under the contract is the
same as that used for these employees and equivalent employees
servicing commercial customers.
(3) If paragraph (k)(1) or (k)(2) of this clause applies—
(i) If the offeror does not certify to the conditions in
paragraph (k)(1) or (k)(2) and the Contracting Officer did not
attach a Service Contract Labor Standards wage determination
to the solicitation, the offeror shall notify the Contracting
Officer as soon as possible; and
(ii) The Contracting Officer may not make an award to the
offeror if the offeror fails to execute the certification in
paragraph (k)(1) or (k)(2) of this clause or to contact the
Contracting Officer as required in paragraph (k)(3)(i) of this
clause.
(l) Taxpayer Identification Number (TIN) (26 U.S.C. 6109, 31
U.S.C. 7701). (Not applicable if the offeror is required to
provide this information to SAM to be eligible for award.)
(1) All offerors must submit the information required in
paragraphs (l)(3) through (l)(5) of this provision to comply
with debt collection requirements of 31 U.S.C. 7701(c) and
3325(d), reporting requirements of 26 U.S.C. 6041, 6041A, and
6050M, and implementing regulations issued by the Internal
Revenue Service (IRS).
(2) The TIN may be used by the Government to collect and report
on any delinquent amounts arising out of the offeror’s
relationship with the Government (31 U.S.C. 7701(c)(3)). If the
resulting contract is subject to the payment reporting
requirements described in FAR 4.904, the TIN provided hereunder
may be matched with IRS records to verify the accuracy of the
offeror’s TIN.
(3) Taxpayer Identification Number (TIN).
□ TIN: ________________________________.
□ TIN has been applied for.
□ TIN is not required because:
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□ Offeror is a nonresident alien, foreign corporation, or
foreign partnership that does not have income effectively
connected with the conduct of a trade or business in the
United States and does not have an office or place of business
or a fiscal paying agent in the United States;
□ Offeror is an agency or instrumentality of a foreign
government;
□ Offeror is an agency or instrumentality of the Federal
Government.
(4) Type of organization.
□ Sole proprietorship;
□ Partnership;
□ Corporate entity (not tax-exempt);
□ Corporate entity (tax-exempt);
□ Government entity (Federal, State, or local);
□ Foreign government;
□ International organization per 26 CFR 1.6049-4;
□ Other ________________________________.
(5) Common parent.
□ Offeror is not owned or controlled by a common parent;
□ Name and TIN of common parent:
Name ________________________________.
TIN _________________________________.
(m) Restricted business operations in Sudan. By submission of its
offer, the offeror certifies that the offeror does not conduct
any restricted business operations in Sudan.
(n) Prohibition on Contracting with Inverted Domestic
Corporations.
(1) Government agencies are not permitted to use appropriated
(or otherwise made available) funds for contracts with either an
inverted domestic corporation, or a subsidiary of an inverted
domestic corporation, unless the exception at 9.108-2(b) applies
or the requirement is waived in accordance with the procedures
at 9.108-4.
(2) Representation. The Offeror represents that—
(i) It □ is, □ is not an inverted domestic corporation; and
(ii) It □ is, □ is not a subsidiary of an inverted domestic
corporation.
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(o) Prohibition on contracting with entities engaging in certain
activities or transactions relating to Iran.
(1) The offeror shall e-mail questions concerning sensitive
technology to the Department of State at [email protected].
(2) Representation and Certifications. Unless a waiver is
granted or an exception applies as provided in paragraph (o)(3)
of this provision, by submission of its offer, the offeror—
(i) Represents, to the best of its knowledge and belief, that
the offeror does not export any sensitive technology to the
government of Iran or any entities or individuals owned or
controlled by, or acting on behalf or at the direction of, the
government of Iran;
(ii) Certifies that the offeror, or any person owned or
controlled by the offeror, does not engage in any activities
for which sanctions may be imposed under section 5 of the Iran
Sanctions Act; and
(iii) Certifies that the offeror, and any person owned or
controlled by the offeror, does not knowingly engage in any
transaction that exceeds $3,500 with Iran’s Revolutionary
Guard Corps or any of its officials, agents, or affiliates,
the property and interests in property of which are blocked
pursuant to the International Emergency Economic Powers Act
(50 U.S.C. 1701 et seq.) (see OFAC’s Specially Designated
Nationals and Blocked Persons List at
https://www.treasury.gov/resource-center/sanctions/SDN-
List/Pages/default.aspx).
(3) The representation and certification requirements of
paragraph (o)(2) of this provision do not apply if—
(i) This solicitation includes a trade agreements
certification (e.g., 52.212-3(g) or a comparable agency
provision); and
(ii) The offeror has certified that all the offered products
to be supplied are designated country end products.
(p) Ownership or Control of Offeror. (Applies in all
solicitations when there is a requirement to be registered in SAM
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
Page 57 of 67
or a requirement to have a unique entity identifier in the
solicitation.)
(1) The Offeror represents that it □ has or □ does not have an
immediate owner. If the Offeror has more than one immediate
owner (such as a joint venture), then the Offeror shall respond
to paragraph (2) and if applicable, paragraph (3) of this
provision for each participant in the joint venture.
(2) If the Offeror indicates “has” in paragraph (p)(1) of this
provision, enter the following information:
Immediate owner CAGE code: ____________________.
Immediate owner legal name: _____________________.
(Do not use a “doing business as” name)
Is the immediate owner owned or controlled by another entity:
□ Yes or □ No.
(3) If the Offeror indicates “yes” in paragraph (p)(2) of this
provision, indicating that the immediate owner is owned or
controlled by another entity, then enter the following
information:
Highest-level owner CAGE code: __________________.
Highest-level owner legal name: ___________________.
(Do not use a “doing business as” name)
(q) Representation by Corporations Regarding Delinquent Tax
Liability or a Felony Conviction under any Federal Law.
(1) As required by sections 744 and 745 of Division E of the
Consolidated and Further Continuing Appropriations Act, 2015
(Pub. L. 113-235), and similar provisions, if contained in
subsequent appropriations acts, The Government will not enter
into a contract with any corporation that—
(i) Has any unpaid Federal tax liability that has been
assessed, for which all judicial and administrative remedies
have been exhausted or have lapsed, and that is not being paid
in a timely manner pursuant to an agreement with the authority
responsible for collecting the tax liability, where the
awarding agency is aware of the unpaid tax liability, unless
an agency has considered suspension or debarment of the
corporation and made a determination that suspension or
debarment is not necessary to protect the interests of the
Government; or
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
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(ii) Was convicted of a felony criminal violation under any
Federal law within the preceding 24 months, where the awarding
agency is aware of the conviction, unless an agency has
considered suspension or debarment of the corporation and made
a determination that this action is not necessary to protect
the interests of the Government.
(2) The Offeror represents that—
(i) It is □ is not □ a corporation that has any unpaid Federal
tax liability that has been assessed, for which all judicial
and administrative remedies have been exhausted or have lapsed,
and that is not being paid in a timely manner pursuant to an
agreement with the authority responsible for collecting the
tax liability; and
(ii) It is □ is not □ a corporation that was convicted of a
felony criminal violation under a Federal law within the
preceding 24 months.
(r) Predecessor of Offeror. (Applies in all solicitations that
include the provision at 52.204-16, Commercial and Government
Entity Code Reporting.)
(1) The Offeror represents that it □ is or □ is not a successor
to a predecessor that held a Federal contract or grant within
the last three years.
(2) If the Offeror has indicated “is” in paragraph (r)(1) of
this provision, enter the following information for all
predecessors that held a Federal contract or grant within the
last three years (if more than one predecessor, list in reverse
chronological order):
Predecessor CAGE code: ________ (or mark “Unknown”)
Predecessor legal name: _________________________
(Do not use a “doing business as” name)
(s) Reserved.
(t) Public Disclosure of Greenhouse Gas Emissions and Reduction
Goals. Applies in all solicitations that require offerors to
register in SAM (12.301(d)(1)).
(1) This representation shall be completed if the Offeror
received $7.5 million or more in contract awards in the prior
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
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Federal fiscal year. The representation is optional if the
Offeror received less than $7.5 million in Federal contract
awards in the prior Federal fiscal year.
(2) Representation. [Offeror to check applicable block(s) in
paragraph (t)(2)(i) and (ii)].
(i) The Offeror (itself or through its immediate owner or
highest-level owner) □ does, □ does not publicly disclose
greenhouse gas emissions, i.e., makes available on a publicly
accessible website the results of a greenhouse gas inventory,
performed in accordance with an accounting standard with
publicly available and consistently applied criteria, such as
the Greenhouse Gas Protocol Corporate Standard.
(ii) The Offeror (itself or through its immediate owner or
highest-level owner) □ does, □ does not publicly disclose a
quantitative greenhouse gas emissions reduction goal, i.e.,
make available on a publicly accessible website a target to
reduce absolute emissions or emissions intensity by a specific
quantity or percentage.
(iii) A publicly accessible website includes the Offeror’s own
website or a recognized, third-party greenhouse gas emissions
reporting program.
(3) If the Offeror checked “does” in paragraphs (t)(2)(i) or
(t)(2)(ii) of this provision, respectively, the Offeror shall
provide the publicly accessible website(s) where greenhouse gas
emissions and/or reduction goals are reported:_________________.
(u)
(1) In accordance with section 743 of Division E, Title VII, of
the Consolidated and Further Continuing Appropriations Act, 2015
(Pub. L. 113-235) and its successor provisions in subsequent
appropriations acts (and as extended in continuing resolutions),
Government agencies are not permitted to use appropriated (or
otherwise made available) funds for contracts with an entity
that requires employees or subcontractors of such entity seeking
to report waste, fraud, or abuse to sign internal
confidentiality agreements or statements prohibiting or
otherwise restricting such employees or subcontractors from
lawfully reporting such waste, fraud, or abuse to a designated
investigative or law enforcement representative of a Federal
department or agency authorized to receive such information.
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(2) The prohibition in paragraph (u)(1) of this provision does
not contravene requirements applicable to Standard Form 312
(Classified Information Nondisclosure Agreement), Form 4414
(Sensitive Compartmented Information Nondisclosure Agreement),
or any other form issued by a Federal department or agency
governing the nondisclosure of classified information.
(3) Representation. By submission of its offer, the Offeror
represents that it will not require its employees or
subcontractors to sign or comply with internal confidentiality
agreements or statements prohibiting or otherwise restricting
such employees or subcontractors from lawfully reporting waste,
fraud, or abuse related to the performance of a Government
contract to a designated investigative or law enforcement
representative of a Federal department or agency authorized to
receive such information (e.g., agency Office of the Inspector
General).
(v) Covered Telecommunications Equipment or Services-
Representation. Section 889(a)(1)(A) of Public Law 115-232.
(1) The Offeror shall review the list of excluded parties in the
System for Award Management (SAM) (https://www.sam.gov ) for
entities excluded from receiving federal awards for "covered
telecommunications equipment or services".
(2) The Offeror represents that–
(i) It□ does, □ does not provide covered telecommunications
equipment or services as a part of its offered products or
services to the Government in the performance of any contract,
subcontract, or other contractual instrument.
(ii) After conducting a reasonable inquiry for purposes of
this representation, that it □ does, □ does not use covered
telecommunications equipment or services, or any equipment,
system, or service that uses covered telecommunications
equipment or services.
(End of Provision)
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FAR 52.229-11 Tax on Certain Foreign Procurements—Notice and
Representation (JUN 2020)
(a) Definitions. As used in this provision—
Foreign person means any person other than a United States person.
Specified Federal procurement payment means any payment made
pursuant to a contract with a foreign contracting party that is
for goods, manufactured or produced, or services provided in a
foreign country that is not a party to an international
procurement agreement with the United States. For purposes of the
prior sentence, a foreign country does not include an outlying
area.
United States person as defined in 26 U.S.C. 7701(a)(30) means—
(1) A citizen or resident of the United States;
(2) A domestic partnership;
(3) A domestic corporation;
(4) Any estate (other than a foreign estate, within the meaning
of 26 U.S.C. 701(a)(31)); and
(5) Any trust if—
(i) A court within the United States is able to exercise primary
supervision over the administration of the trust; and
(ii) One or more United States persons have the authority to
control all substantial decisions of the trust.
(b) Unless exempted, there is a 2 percent tax of the amount of a
specified Federal procurement payment on any foreign person
receiving such payment. See 26 U.S.C. 5000C and its implementing
regulations at 26 CFR 1.5000C-1 through 1.5000C-7.
(c) Exemptions from withholding under this provision are described
at 26 CFR 1.5000C-1(d)(5) through (7). The Offeror would claim an
exemption from the withholding by using the Department of the
Treasury Internal Revenue Service Form W-14, Certificate of
Foreign Contracting Party Receiving Federal Procurement Payments,
available via the internet at www.irs.gov/w14. Any exemption
claimed and self-certified on the IRS Form W-14 is subject to
audit by the IRS. Any disputes regarding the imposition and
collection of the 26 U.S.C. 5000C tax are adjudicated by the IRS
as the 26 U.S.C. 5000C tax is a tax matter, not a contract issue.
The IRS Form W-14 is provided to the acquiring agency rather than
to the IRS.
(d) For purposes of withholding under 26 U.S.C. 5000C, the Offeror
represents that—
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
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(1) It [__]is [__]is not a foreign person; and
(2) If the Offeror indicates “is” in paragraph (d)(1) of this
provision, then the Offeror represents that—I am claiming on the
IRS Form W-14 [____] a full exemption, or [____] partial or no
exemption [Offeror shall select one] from the excise tax.
(e) If the Offeror represents it is a foreign person in paragraph
(d)(1) of this provision, then—
(1) The clause at FAR 52.229-12, Tax on Certain Foreign
Procurements, will be included in any resulting contract; and
(2) The Offeror shall submit with its offer the IRS Form W-14. If
the IRS Form W-14 is not submitted with the offer, exemptions
will not be applied to any resulting contract and the Government
will withhold a full 2 percent of each payment.
(f) If the Offeror selects “is” in paragraph (d)(1) and “partial
or no exemption” in paragraph (d)(2) of this provision, the
Offeror will be subject to withholding in accordance with the
clause at FAR 52.229-12, Tax on Certain Foreign Procurements, in
any resulting contract.
(g) A taxpayer may, for a fee, seek advice from the Internal
Revenue Service (IRS) as to the proper tax treatment of a
transaction. This is called a private letter ruling. Also, the IRS
may publish a revenue ruling, which is an official interpretation
by the IRS of the Internal Revenue Code, related statutes, tax
treaties, and regulations. A revenue ruling is the conclusion of
the IRS on how the law is applied to a specific set of facts. For
questions relating to the interpretation of the IRS regulations go
to https://www.irs.gov/help/tax-law-questions. (End of provision)
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
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5.2 Addendum to Representations and Certifications - FAR and DOSAR
Provisions not Prescribed in Part 12
FAR 52.204-24 Representation Regarding Certain Telecommunications
and Video Surveillance Services or Equipment (OCT 2020)
The Offeror shall not complete the representation at paragraph
(d)(1) of this provision if the Offeror has represented that it
"does not provide covered telecommunications equipment or services
as a part of its offered products or services to the Government in
the performance of any contract, subcontract, or other contractual
instrument" in paragraph (c)(1) in the provision at 52.204-26,
Covered Telecommunications Equipment or Services—Representation, or
in paragraph (v)(2)(i) of the provision at 52.212-3, Offeror
Representations and Certifications-Commercial Items. The Offeror
shall not complete the representation in paragraph (d)(2) of this
provision if the Offeror has represented that it "does not use
covered telecommunications equipment or services, or any equipment,
system, or service that uses covered telecommunications equipment or
services" in paragraph (c)(2) of the provision at 52.204-26, or in
paragraph (v)(2)(ii) of the provision at 52.212-3.
(a) Definitions. As used in this provision—
Backhaul, covered telecommunications equipment or services,
critical technology, interconnection arrangements, reasonable
inquiry, roaming, and substantial or essential component have the
meanings provided in the clause 52.204-25, Prohibition on
Contracting for Certain Telecommunications and Video Surveillance
Services or Equipment.
(b) Prohibition.
(1) Section 889(a)(1)(A) of the John S. McCain National Defense
Authorization Act for Fiscal Year 2019 (Pub. L. 115-232)
prohibits the head of an executive agency on or after August 13,
2019, from procuring or obtaining, or extending or renewing a
contract to procure or obtain, any equipment, system, or service
that uses covered telecommunications equipment or services as a
substantial or essential component of any system, or as critical
technology as part of any system. Nothing in the prohibition
shall be construed to—
(i) Prohibit the head of an executive agency from procuring with
an entity to provide a service that connects to the facilities
of a third-party, such as backhaul, roaming, or interconnection
arrangements; or
(ii) Cover telecommunications equipment that cannot route or
redirect user data traffic or cannot permit visibility into any
user data or packets that such equipment transmits or otherwise
handles.
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Page 64 of 67
(2) Section 889(a)(1)(B) of the John S. McCain National Defense
Authorization Act for Fiscal Year 2019 (Pub. L. 115-232)
prohibits the head of an executive agency on or after August 13,
2020, from entering into a contract or extending or renewing a
contract with an entity that uses any equipment, system, or
service that uses covered telecommunications equipment or
services as a substantial or essential component of any system,
or as critical technology as part of any system. This prohibition
applies to the use of covered telecommunications equipment or
services, regardless of whether that use is in performance of
work under a Federal contract. Nothing in the prohibition shall
be construed to—
(i) Prohibit the head of an executive agency from procuring with
an entity to provide a service that connects to the facilities
of a third-party, such as backhaul, roaming, or interconnection
arrangements; or
(ii) Cover telecommunications equipment that cannot route or
redirect user data traffic or cannot permit visibility into any
user data or packets that such equipment transmits or otherwise
handles.
(c) Procedures. The Offeror shall review the list of excluded
parties in the System for Award Management (SAM)
(https://www.sam.gov) for entities excluded from receiving federal
awards for "covered telecommunications equipment or services".
(d) Representation. The Offeror represents that—
(1) It ___ will, ___ will not provide covered telecommunications
equipment or services to the Government in the performance of any
contract, subcontract or other contractual instrument resulting
from this solicitation. The Offeror shall provide the additional
disclosure information required at paragraph (e)(1) of this
section if the Offeror responds "will" in paragraph (d)(1) of
this section; and
(2) After conducting a reasonable inquiry, for purposes of this
representation, the Offeror represents that—
It ___ does, ___ does not use covered telecommunications
equipment or services, or use any equipment, system, or service
that uses covered telecommunications equipment or services. The
Offeror shall provide the additional disclosure information
required at paragraph (e)(2) of this section if the Offeror
responds "does" in paragraph (d)(2) of this section.
(e) Disclosures.
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
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(1) Disclosure for the representation in paragraph (d)(1) of this
provision. If the Offeror has responded "will" in the
representation in paragraph (d)(1) of this provision, the Offeror
shall provide the following information as part of the offer:
(i) For covered equipment—
(A) The entity that produced the covered telecommunications
equipment (include entity name, unique entity identifier, CAGE
code, and whether the entity was the original equipment
manufacturer (OEM) or a distributor, if known);
(B) A description of all covered telecommunications equipment
offered (include brand; model number, such as OEM number,
manufacturer part number, or wholesaler number; and item
description, as applicable); and
(C) Explanation of the proposed use of covered
telecommunications equipment and any factors relevant to
determining if such use would be permissible under the
prohibition in paragraph (b)(1) of this provision.
(ii) For covered services—
(A) If the service is related to item maintenance: A
description of all covered telecommunications services offered
(include on the item being maintained: Brand; model number,
such as OEM number, manufacturer part number, or wholesaler
number; and item description, as applicable); or
(B) If not associated with maintenance, the Product Service
Code (PSC) of the service being provided; and explanation of
the proposed use of covered telecommunications services and
any factors relevant to determining if such use would be
permissible under the prohibition in paragraph (b)(1) of this
provision.
(2) Disclosure for the representation in paragraph (d)(2) of this
provision. If the Offeror has responded "does" in the
representation in paragraph (d)(2) of this provision, the Offeror
shall provide the following information as part of the offer:
(i) For covered equipment—
(A) The entity that produced the covered telecommunications
equipment (include entity name, unique entity identifier, CAGE
code, and whether the entity was the OEM or a distributor, if
known);
(B) A description of all covered telecommunications equipment
offered (include brand; model number, such as OEM number,
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
Page 66 of 67
manufacturer part number, or wholesaler number; and item
description, as applicable); and
(C) Explanation of the proposed use of covered
telecommunications equipment and any factors relevant to
determining if such use would be permissible under the
prohibition in paragraph (b)(2) of this provision.
(ii) For covered services—
(A) If the service is related to item maintenance: A
description of all covered telecommunications services offered
(include on the item being maintained: Brand; model number,
such as OEM number, manufacturer part number, or wholesaler
number; and item description, as applicable); or
(B) If not associated with maintenance, the PSC of the service
being provided; and explanation of the proposed use of covered
telecommunications services and any factors relevant to
determining if such use would be permissible under the
prohibition in paragraph (b)(2) of this provision.
(End of provision)
Addendum to Solicitation Provisions - FAR and DOSAR Provisions not
Prescribed in Part 12
FAR 52.252-1 Solicitation Provisions Incorporated by Reference (FEB
1998)
This solicitation incorporates one or more solicitation provisions
by reference, with the same force and effect as if they were given
in full text. Upon request, the Contracting Officer will make their
full text available. The offeror is cautioned that the listed
provisions may include blocks that must be completed by the offeror
and submitted with its quotation or offer. In lieu of submitting the
full text of those provisions, the offeror may identify the
provision by paragraph identifier and provide the appropriate
information with its quotation or offer. Also, the full text of a
solicitation provision may be accessed electronically at this
address:
https://www.acquisition.gov/browse/index/far
If the Federal Acquisition Regulation (FAR) is not available at the
location indicated above, use the Department of State Acquisition
website at e-CFR to see the links to the FAR. You may also use an
Internet “search engine” (for example, Google, Yahoo or Excite) to
obtain the latest location of the most current FAR.
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
Page 67 of 67
The following Federal Acquisition Regulation (FAR) solicitation
provisions are incorporated by reference:
FAR 52.225-25 Prohibition on Contracting with Entities Engaging in
Certain Activities or Transactions Relating to Iran—Representation
and Certifications (JUN 2020)
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
Attachment 1, 2, and 3
ATTACHMENT 1
DESCRIPTION/SPECIFICATIONS/PERFORMANCE WORK STATEMENT
The Contractor will be responsible for being familiar with Japanese
laws and possess demonstrated ability for obtaining all licenses,
permits and other official requirements allowing for the cooking of
food items in the Marine Security Guard Residence (MSGR). When
requested by the MSG Mess Non-Commissioned Officer (NCO), the
Contractor may be required to accompany the Mess NCO on local food
purchasing trips.
The Contractor shall provide all management, supervision,
administrative support, labor, logistics, training, and transportation
required to conduct food service operations.
The USG requires a variety of food services operations services
including, but not limited to:
Menu Planning and Coordination
Food Provisioning
Food Preparation and Service
Food Service Staffing
Quality Management
The Contractor shall follow all relevant applicable industry
standards, codes, Government regulations, DOS guidance and written
supplier’s recommendations in executing the services of this contract.
The Contractor shall provide all Dining services for the Marine
Security Guard Residence (MSGR) located at –
Marine Security Guard Residence, 2-1-1 Roppongi, Minato-ku, Tokyo
Clientele consist of Marine Security Guards (MSGs) working on the
Embassy/Consulate compound.
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
Attachment 1, 2, and 3
Hours of Operation: The hours of operation will follow the established
hours for food service operations
Weekdays
Breakfast:
0730-1000
Lunch:
1100-1530
-upon request by Marine
Dinner:
- making and putting in fridge for later consumption by Marines
&
On Friday, make enough quantity of 2 more dinner options to last
through Saturday and Sunday. No premade breakfast or lunch unless
requested by Marine.
1. General Requirements
The Contractor shall implement a DOS-approved food services support
program to standardize food operations, meet mission requirements,
control costs and provide good service to the MSG Detachment. The
Contractor’s food services approach will incorporate change
management to support an evolving DOS approved business plan to meet
situational changes.
Objectives
Provide a proper skill mix, and experience of qualified personnel
High Quality Food Operations, with minimal disruptions during
transitions
Control Cost of Food Services
Provide effective internal controls and management oversight in
support of effective organizational processes
Demonstrate an innovative approach to food operations
Provide high level of customer satisfaction
When required, assist the MSG Mess NCO in identifying high
quality food for meal preparation
Code, Regulations, Guidance and Standards
FDA Food Code - www.fda.gov/foodcode
USDA Grades and Standards - https://www.ams.usda.gov/grades-
standards
CODEX Alimentarius - http://www.fao.org/fao-who-
codexalimentarius/standards/en/
Note: The above links are provided as a courtesy. The Government is
not responsible for updating the links.
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
Attachment 1, 2, and 3
Licensing, Laws, and Regulations
The Contractor shall make certain that the proper Japanese licensing
and approvals are in place for employee(s) to be in full compliance
with the laws and regulations.
2. Specific Requirements
a. Food Service Operations
i. Hours of Operation.
Hours of operation will follow the U.S. Government established
hours for food service operations.
Kitchen Services
Facility
Breakfast
Hours
Lunch
Hours
Dinner
Hours
MSGR 7:00-10:00 11:00-15:30 No hours
ii. Quantities of Meals.
The MSG detachment at U.S. Embassy Tokyo consists of up to 14
Marines, which would require the preparation of 56 meals per day,
respectively.
iii. Menu
The MSGR patrons are a diverse group: Americans who have traveled
extensively and been exposed to many cultures as well as those who
prefer their own regional cuisines in the U.S.; and individuals
who have dietary restrictions for health, cultural or religious
reasons.
Trying to please everyone all the time is labor intensive,
expensive, and a near impossible task. But making the small steps
will be appreciated.
In coordination with the Mess NCO, the Contractor will develop a
20-day menu cycle, offering a variety of food selections for each
meal and on a weekly basis, based upon acceptability ratings,
availability of food items, and food preparation limitations, as
well as cost of operations. The menu shall consist of a variety of
quality prepared foods that meet business and industry standards,
complying with the current and subsequent revisions of Dietary
Guidelines for Americans (www.health.gov) offering menu
alternatives that are low in total fat, saturated fat,
cholesterol, sodium and sugar; no trans fats; lean meats; low-fat
dairy products; a variety of vegetables, fruits and grain
products; and vegetarian selections. The quality and appearance of
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
Attachment 1, 2, and 3
the food shall be consistent with approved food service industry
standards for comparable “business and industry” dining
facilities.
The menu should incorporate local/regional cuisine, American and
international dishes. There should be at least one healthy option
with each meal. Full use of leftovers can also extend the
selection if items are stored and labeled in accordance with food
safety standards.
Special meals (e.g. Mexican night, Italian supper, Asian stir-fry
luncheon) are also possible introductions. A suitable selection
for any identified vegetarian diners shall be on the menu daily as
well.
It will be the responsibility of the COR or the Mess NCO to advise
the Contractor of any special dietary or cultural limitations. In
the event the Contractor receives no notification it can be
assumed none exists. ONLY the COR or the Mess NCO has the
authority to make these notifications.
(1) Menu Planning
The Contractor, in coordination with the Mess NCO, shall
establish 20-day menus that reflect meals variety consistent with
the varied cultural, religious, and health dietary requirements
of the MSGs. Menu items shall be fresh, prepared onsite,
healthy, modern and authentic to the maximum extent practicable.
Contractor shall utilize accepted cooking standards for food
preparation and develop program specific standards to ensure
consistency in preparation across the program.
Contractor shall develop standards or recipe cards for items
determined to be customer favorites. Cooking standards and
recipes shall be available to the COR and included as part of
program quality assurance program.
(2) Menu Adjustments
The Contractor will submit adjustments to the menus to the COR
one week in advance, in writing for approval.
iv. Concept of Operations
Food is an important morale factor, as are the health priorities
of a good diet. A successful food operation will be one that
continuously pleases the diners; offers a wide variety of food
choices; accommodates different dietary needs and desires based
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
Attachment 1, 2, and 3
upon personal choice, ethnic experience and religious
restrictions; is environmentally sustainable, exceeds goals,
generates useful metrics and provides excellent service in all
areas.
Food is a “high risk” area. It can negatively affect health,
adversely affect morale, be impacted by political and economic
events, and be a source for fraud, waste and abuse. The planning
and resourcing that will go into this effort cannot be changed
quickly. Overseas, the options are severely limited, and
resources are few. The contractor shall provide an approach that
measures performance and capitalizes on success while planning to
mitigate such risk factors.
In order to normalize food operations, the Contractor shall have
an ultimate goal of achieving a system that is: efficient; reduces
waste; provides sufficient variety allowing the diner to make
choices based on nutrition and variety; and is a pleasant
experience overall.
The Contractor shall make use of local supplies for common and
available items, local, regional, and international dishes while
utilizing international sources for main entrée items, as well as
favorites (USA brand items). Planning for the menu should account
for available provisions.
The Contractor will staff and supply meals in accordance with meal
hours and meal service specified in Section 1, 2.3 Locations, and
4.1.1 Hours of Operation.
V. Establishment of Facilities
The Contractor shall establish food service operations located
within the MSGR. The Contractor shall coordinate with the COR on
any additional equipment needs that are identified during the
solicitation process.
Patrons will be expected to clean up after the meal by taking
their dinnerware and trash to a designated site for turn-in and/or
disposal. However, the Contractor is responsible for Cleanliness
services at the MSGR and shall clean and put away the dishes
daily. The designated site shall accommodate efforts to recycle
plastics, glass, and paper apart from compostable food waste.
vi. Standards of Service
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
Attachment 1, 2, and 3
Contractor shall maintain a standard of service equal to our
better than quality commercial food service operations found on
university campuses, finer hotels and resorts.
(1) Preparation
Contractor shall utilize the appropriate industry preparation
standards for the all food products and menu items. Contractor
shall ensure all food is not overcooked or undercooked, over
seasoned or under seasoned.
(2) Presentation
Food will not only be delicious, but well presented, readily
replenished, and served at the right temperature for food safety
requirements as well as patron expectations. Contractor shall
use fresh ingredients to the maximum extent possible and use
varying colors and arrangement that are pleasing to the eye.
Serving areas, equipment, pans and serving bowls shall be clean,
well-lit and free of drips and food particles. Serving utensils
shall be replaced regularly throughout service to reduce cross
contamination and provide a clean appearance.
(3) Green Program and Waste Minimization
The Contractor shall utilize environmentally friendly cleaning
products to the maximum extent practicable. The Contractor will
demonstrate waste minimization through establishing historical
usage, accurate forecasting, progressive cooking, and tracking of
waste to continuously improve performance.
The Contractor will participate in “Sustainability Programs” that
may include: disposable bulk purchasing program, organic food
products, organic or environmentally friendly cleaning products,
reusable items, marketing programs, minimizing waste stream,
energy and water saving programs (equipment, food preparation,
etc.) and other “green” programs that will benefit the patrons,
the workers, DOS and the host nation.
Contractor shall work to reduce and replace the use of disposable
dining ware through expansion of dishwashing operations to the
maximum extent practical.
(4) Customer Service
The Contractor’s food service worker(s) will be knowledgeable,
provide excellent customer service, be pleasant, and achieve
compliance with U.S. food worker health standards. Staff shall
greet customers with a smile and appropriate greeting. Staff
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
Attachment 1, 2, and 3
shall be polite and address all customers with respect. Staff
shall look to assist guests to the maximum extent practical.
(5) Food Handling and Safety
Food standards will be in accordance with the World Trade
Organization recognized Codex Alimentarius. The Codex
Alimentarius is an international reference point for the
resolution of disputes concerning food safety and consumer
protection.
General Standards – Safety
As part of the Program Management Plan, the Contractor shall
establish a Food Service Safety Program. The Contractor’s Food
Service workers will employ appropriate safety gear in the course
of their work. The Contractor’s Safety Program shall include
documented training and refresher courses for all personnel,
evidence of which will be provided to the Government upon
request. Language accommodation for LNs may be required. The
Contractor shall investigate, and record events involving
personal injury or significant damage to DOS facilities and
report these events to the COR. To prevent future incidents, the
Contractor will verify Safety Program reports are part of Program
and Quality Assurance (QA) reviews.
(6) Food Worker Health, Sanitation, and Hygiene
FDA and USDA Service Guidelines
The Contractor will follow current Food Service Sanitation and
Public Health Service standards, and FDA and USDA food service
guidelines, codes, and regulations. The contractor will monitor
host nation evolution to World Health Organization (WHO)
guidelines, including Codex Alimentarius, and incorporate WHO
guidelines into its approach as appropriate.
Health and Sanitation Inspections
The Contractor will maintain and retain reports on health and
sanitation inspections.
Food Service Management
The Contractor will train food service management and service
staff in National Restaurant Association ServSafe food handling
procedures.
Food-Handling Awareness
The Contractor will provide periodic health, sanitation, and
hygiene training to address food handling awareness and
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
Attachment 1, 2, and 3
sanitation processes for all employees assigned to the residence
as part of this contract.
Fit for Duty
All Food Service workers will be physically capable, certified
communicable disease-free, and attired in clean clothing.
Health Certifications
All Food Service workers shall possess health certificates.
Health certifications shall be made by medical examination with
copies of exam documentation retained at the MSGR for inspection.
(7) Cleanliness
As part of the operation of the MSGR kitchen, the Contractor
shall provide cleaning services. These services shall be
performed in accordance with standard commercial cleaning
practices. The MSGR kitchen and dinning areas require regular
cleaning of all visible dust, grease, dirt, soil, scuff marks,
and debris from surfaces, fixtures, tables, walls, floors and
carpets due to regular traffic. Additional standard cleaning
services include, but are not limited to, the following: table
bussing/cleaning during food service operations, sweeping,
mopping, trash removal, washing kitchen/dining windows,
disinfecting, cleaning entryways and mats, and basic metal
polishing.
The Contractor shall also clean and put away dishes daily while
they are at work.
All indoor and outdoor kitchen/cafeteria spaces will be kept
clean and sanitized to the highest U.S. standards.
vii. Food Service Management System and Controls
Food Service Management System
The Contractor will implement and/or maintain a Food Service
Manage System for maintaining accountability and limiting access
to authorized patrons. With tracking and database tools for the
Contractor’s program office, and storage facilities, the system
will be a flexible and transparent inventory management solution.
The system will enable the Contractor to monitor inventory levels,
streamline purchasing, develop menus, standardize recipes, analyze
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
Attachment 1, 2, and 3
data, and accurately report on a wide range of food service
activities and metrics.
Access Control
The Contractor shall implement planning and access controls to
ensure only authorized employees are able to access the MSGR.
Fraud, Waste, and Abuse
The Contractor will have procedures, processes, and systems in
place to detect and eliminate fraud, waste, and abuse.
b. Food Provisioning and Storage
The Contractor shall provide all oversight, labor, materials,
equipment, insurance and overhead to provide food provisions and
storage services required to operate the MSGR kitchen.
i. Food Quality Standards
The quality of product shall be equivalent to standards
established by USDA Agriculture Marketing Service Grades and
Standards ((https://www.ams.usda.gov/grades-standards), or better.
ii. U.S. and Familiar Brands
Patrons are American citizens that associate certain name brand
products to high quality. Local products may be submitted, with
approval for “equal”.
iii. Supply Chain Management
Best Value
Sources should be procured wherever possible to ensure highest
quality and best value.
Receipt of Supplies
The Contractor may be required to accompany the Mess NCO on local
food purchasing trips. These items will be received and stored in
the appropriate areas within the MSGR.
Supply Rotation
All products in storage shall be dated and rotated for first-in,
first-out distribution. Supplies required include:
Food
Food (perishable and non-perishable).
Beverages
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
Attachment 1, 2, and 3
Beverages to include all bottled water, milk, carbonated
beverages, juices, coffee, and tea.
Emergency Food Supply Plan
The Contractor will provide and shall update the incorporated
emergency supply management plan as needed, or upon request from
the Government.
Prevent Spoilage
The Contractor’s Food Service Supervisors and cooks will follow
USDA, HHS, and PHS published guidelines for procedures and
processes to prevent spoilage. They shall consider regular
inventory inspection, temperature rotations, the practice of
first-in, first-out (FIFO), increased physical security for
inventory, and selective or exclusive inventory access limitation.
iv. Supplies, Utensils, Dishware and Consumables
The USG will provide sufficient supplies, utensils, dishware and
consumables to support the MSGR food service operations, with
sufficient inventory to maintain operation for up to 30 days
without re-stock. If levels fall below those required, the
contractor must notify USG within 30 days so that no lapse in
supplies/consumables will occur.
Supplies
Supplies include food supplies associated consumables (e.g.
napkins, paper plates, plastic utensils, to-go boxes, etc.).
Utensils
Utensils include metal cutlery, serving spoons, pots, pans,
kitchen crockery and cooking vessels.
Dining Ware
Dining ware, to include plates, bowls, glasses, and mugs.
c. Equipment and Facilities
The Contractor will operate fully furnished MSGR kitchens provided
by the USG. The Contractor will be provided Government Furnished
Equipment (GFE) that is up-to-date and fully maintained.
Contractor shall conduct a thorough assessment of all existing MSGR
kitchens, and food service management equipment and ensure adequate
supply of replacement equipment and parts are available for
continuous operation.
Offeror shall propose an estimated list of required additional
equipment to the Government for purchase within proposal, if
required.
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
Attachment 1, 2, and 3
Maintenance Plan
The Embassy Operations & Maintenance contract (i.e. a separate
contract) is responsible for the maintenance and repair of all MSGR
kitchens (structure, electrical, plumbing, etc.) and its installed
equipment (hoods, stoves, ovens, dishwashers, etc.). The Contractor
will establish a plan for use, and inventory of all property,
equipment, and materials used in contract performance. Procedures
shall verify that property, equipment, and materials are used solely
for purposes authorized in the contract.
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
Attachment 1, 2, and 3
ATTACHMENT 2
GOVERNMENT FURNISHED PROPERTY
The Government shall make the following property available to the
Contractor as "Government furnished property (GFE)" under the
contract:
2 Extra Large Fridges
1 Extra Large Freezer
1 Large fridge/freezer
1 Stove/oven
2 Sinks
1 Air fryer
2 Microwaves
Dishwasher
Pots/pans
Cooking trays
Spoons
Forks
Knives
Pantry area
Blender
Cooking utensils i.e. spatula, tongs
The Contractor is responsible for informing the COR, in writing, of
GFE malfunctions within 24 hours of the occurrence. The Government
will provide available equipment spares.
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
Attachment 1, 2, and 3
ATTACHMENT 3
JAPANESE HOLIDAYS DURING YEAR 2021
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
Attachment 4
Page 1 of 3
Attachment 4 - English Speaking Levels
Speaking Level 1 (Elementary Proficiency)
Able to satisfy minimum courtesy requirements and maintain very
simple face-to-face conversations on familiar topics.
A native speaker must often use slowed speech, repetition, paraphrase, or a combination of these to be understood by this
individual.
Similarly, the native speaker must strain and employ real-world knowledge to understand even simple statements/questions from this
individual.
This speaker has a functional, but limited proficiency. Misunderstandings are frequent, but the individual is able to ask for help and to verify comprehension of native speech in face-to-
face interaction.
The individual is unable to produce continuous discourse except with rehearsed material.
Examples:
1. Structural accuracy is likely to be random or severely limited.
2. Time concepts are vague.
3. Vocabulary is inaccurate, and its range is very narrow.
4. The individual often speaks with great difficulty.
5. By repeating, such speakers can make themselves understood to
native speakers who are in regular contact with foreigners but there
is little precision in the information conveyed.
6. Needs, experience, or training may vary greatly from individual
to individual; for example, speakers at this level may have
encountered quite different vocabulary areas.
7. However, the individual can typically satisfy predictable,
simple, personal and accommodation needs; can generally meet
courtesy, introduction, and identification requirements; exchange
greetings; elicit and provide, for example, predictable and skeletal
biographical information.
8. He/she might give information about business hours, explain
routine procedures in a limited way, and state in a simple manner
what actions will be taken.
9. He/she is able to formulate some questions even in languages with
complicated question constructions.
10. Almost every utterance may be characterized by structural errors
and errors in basic grammatical relations.
11. Vocabulary is extremely limited and characteristically does not
include modifiers.
12. Pronunciation, stress, and intonation are generally poor, often
heavily influenced by another language.
13. Use of structure and vocabulary is highly imprecise.
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
Attachment 4
Page 2 of 3
Speaking Level 2 (Limited Working Proficiency)
Able to satisfy routine social demands and limited work requirements.
Can handle routine work-related interactions that are limited in scope.
In more complex and sophisticated work-related tasks, usage generally disturbs the native speaker.
Can handle with confidence, but not with facility, most normal high-frequency social conversational situations, including
extensive but casual conversations about current events, as well
as work, family, and autobiographical information.
The individual can comprehend most everyday conversations, but has some difficulty understanding native speakers in situations that
require specialized or sophisticated knowledge.
The individual’s utterances are minimally cohesive to articulate basic concepts.
Linguistic structure is usually not very elaborate and not thoroughly controlled; errors are frequent.
Vocabulary use is appropriate for high-frequency utterances, but unusual or imprecise elsewhere.
Examples:
1. While these interactions will vary widely from individual to
individual, the individual can typically ask and answer predictable
questions in the workplace and give straightforward instructions to
subordinates.
2. The individual can participate in personal and accommodation-type
interactions with elaboration and facility; that is, can give and
understand complicated, detailed and extensive directions and make
non-routine changes in travel and accommodation arrangements.
3. Simple structures and basic grammatical relations are typically
controlled; however, there are areas of weakness.
4. In the commonly taught languages, these [areas of weakness] may
be simple markings such as plurals, articles, linking words, and
negatives, or more complex structures such as tense/aspect usage,
case morphology, passive constructions, word order, and embedding.
Request for Quotations (RFQ) No. 19JA80-21-Q-0307
Attachment 4
Page 3 of 3
Speaking Level 3 (General Professional Proficiency)
Able to speak the language with sufficient structural accuracy and
vocabulary to participate effectively in most formal and informal
conversations on practical, social, and professional topics.
Nevertheless, the individual’s limitations generally restrict the professional contexts of language use to matters of shared
knowledge and/or international convention.
Discourse is cohesive. The individual uses the language acceptably, but with some noticeable imperfections; yet, errors virtually never interfere
with understanding and rarely disturb the native speaker.
The individual can effectively combine structure and vocabulary to convey his/her meaning accurately.
The individual speaks readily and fills pauses suitably. In face-to-face conversation with natives speaking the standard dialect at a normal rate of speech, comprehension is quite
complete.
Although cultural references, proverbs, and the implications of nuances and idiom may not be fully understood, the individual can
easily repair the conversation.
Pronunciation may be obviously foreign. Individual sounds are accurate; but stress, intonation, and pitch control may be faulty.
Examples:
1. Can typically discuss particular interests and special fields of
competence with reasonable ease.
2. Can use the language as part of normal professional duties such
as answering objections, clarifying points, justifying decisions,
understanding the essence of challenges, stating and defending
policy, conducting meetings, delivering briefings, or other extended
and elaborate informative monologues.
3. Can reliably elicit information and informed opinion from native
speakers.
4. Structural inaccuracy is rarely the major cause of
misunderstanding.
5. Use of structural devices is flexible and elaborate.
6. Without searching for words or phrases, the individual uses the
language clearly and relatively naturally to elaborate concepts
freely and make ideas easily understandable to native speakers.
7. Errors occur in low frequency and highly complex structures.
Request for Quotation (RFQ) No. 19JA80-21-Q-0307
Attachment 5 - RSO Tokyo Security Form
Use number 19 if you need extra space for your detailed answers.
2. Alias/Maiden name
/ / (LAST /苗字) (First/名前) (Middle)
Year Month Day 4. Nationality 国籍
10. Previous addresses of past 7 years. From present to past. (過去7年間の住所を新しい順に。)
Duration 期間 Address 住所
(例'98年4月~'00年9月 〒107-0051 東京都港区赤坂1-10-5)
Regional Security Office Tokyo Security Form
7. Permanent
Address
8. Present Address
別姓・旧姓
1. Name
6. Place of Birth (City/State) 出生地(都道府県/区市町村)
3. Date of Birth
生年月日
PHOTO
氏名
年 月 日
現 住 所 〒
9. TEL : CELL: EMAIL:
□ □ □
本 籍 地
□5. Marital Status 婚暦
Single
独身
Married
婚姻
Widowed
寡婦/夫
Divorced
離婚
Please type or write in legible block letters.
和文・英文両方で明確に書いて下さい。 英文に関しては、タイプするか活字体で記入して下さい。
(記入欄が不足した場合には、設問19にそれぞれの番号を付した上、ご記入ください。)
Request for Quotation (RFQ) No. 19JA80-21-Q-0307
Attachment 5 - RSO Tokyo Security Form
〒
〒
〒
13. Biological Sketch (Parents, Spouse, Children, Siblings, In-Laws)
家族構成(両親、配偶者、子供、兄弟姉妹、義父母)
職業(具体的に) 居住地(町, 国)
Residence(City,Country)
名前 関係
DOB Nationality Occupation (Detailed)
(From/ To/ Name of Company / Address, 期 間 / 会 社 名 / 所 在 地)
Name Relationship
学部・学科
Name of Company/ 就業先名
12. Employments of past 7 years. From present to past. (過去7年間の職業。新しい順に)
期間
~
DATES ADDRESS
11. Last Education (最終学歴)
NAME OF SCHOOL DEPARTMENT, MAJOR
(日本在住の参考人3名、住所と電話番号。家族及び親戚を除く。)
14. Three References residing in Japan: Do not include family or relatives.
生年月日
~
Dates/期間
国籍
Name / 名 前
父 (Father)
母 (Mother)
~
勤務先, 就学先名 郵便番号 Telephone/ 電話番号
学校名 住所
~
Address / 住 所
Address and Phone Number/ 住所、電話番号
~
~
~
~
Request for Quotation (RFQ) No. 19JA80-21-Q-0307
Attachment 5 - RSO Tokyo Security Form
警察に逮捕されたことがありますか?あれば警察名、年月日、場所、理由、処分等を記入してください。
□□
□
□□□過去に身体的制約(ハンディキャップ)を持っていた、もしくは現在持っていますか?
神経系疾患を患った事がありますか?
Are you now under a physician's care?
YES
薬物、麻薬もしくはアルコール依存の症状がありますか?
Do you have a drug, narcotic or alcohol addiction?
過去12ヶ月内で酒類や薬物を過剰に摂取しましたか?
Within the past 12 months, have you used intoxicating beverages or drug to excess?
結核を患った事がありますか?
"YES" の回答があれば,設問19に詳細を書き込んでください。
□□
Have you ever had tuberculosis?
□
Have you now or have you ever had any physical limitations?
NO
□
16. Health Conditions 健康状態(If answer is "YES" please give details under Item #19.)
17. Have you ever been arrested or detained by any police or military authority? If so, name the authority,
give the time, place and reason for arrest or detention and the disposition of court action.
Have you ever had a nervous disorder?
□□
現在、医師にかかっていいますか?
ToCountry 国名
DATES 期間
FromType of Visa ビザ Pirpose 目的
最寄りの駅より自宅までの地図を詳細に書いて下さい。
渡航暦 (現在から過去7年まで遡って記入してください。)
15. Travel History (List your overseas travel in the last 7 years, start with most recent one.)
18. Draw a map of your residence to the nearest train station using the space below.
Request for Quotation (RFQ) No. 19JA80-21-Q-0307
Attachment 5 - RSO Tokyo Security Form
19. Use this space for detailed answers. Number answers to correspond with the questions. Use extra blank pages, if
necessary.
空欄を使用し、設問の番号と共に回答の詳細を記入してください。必要であれば空白のページを追加して下さい。
Signature (署 名) Date (日付)
This is to certify that the information provided herein is true to the best of my knowledge.
以上相違ありません。